Coding and Billing

As of January 1, 2014, Vermont Medicaid covers up to 16 face-to-face smoking cessation counseling sessions per calendar year for eligible members of any age who use tobacco. This coverage applies when furnished by (or under the direction of) a physician or by any other health care professional who is legally authorized to furnish such services under state law and licensure. “Qualified” Tobacco Cessation Counselors are also allowed (requires at least eight hours of training in tobacco cessation services from an accredited institute of higher education).

Codes with Definitions

Use the following medical codes to correctly capture the diagnosis for tobacco and bill smoking and tobacco cessation counseling.

99406
Smoking and tobacco use cessation counseling visit; immediate greater than 3 minutes up to 10 minutes

99407
Smoking and tobacco use cessation counseling visit, intensive greater than 10 minutes

99407HQ
Smoking and tobacco use cessation counseling visit, intensive greater than 10 minutes, Group Session

D1320
Smoking and tobacco use cessation counseling visit, for the control and prevention of oral disease

Asthma- and Tobacco-Related Billing and Reimbursement Recommendations (PDF)