MEDICAID AND UNINSURED TOBACCO CESSATION BENEFITS
In Vermont, low-income or disabled individuals up to 138 percent of the federal poverty level are covered by Medicaid. As of January 1, 2014, Vermont Medicaid covers tobacco treatment reimbursement for your practice as a preventive service. This includes:
16 face-to-face smoking cessation counseling sessions per year with an authorized health care professional (applies to in-person and telehealth sessions)
4 sessions of 802Quits individual, group and phone counseling
All 7 FDA-approved smoking cessation medications including 24 weeks of Chantix® or Zyban®
No limit on preferred quit medications including gum, patches and Nicorette® lozenges and up to 16 weeks of non-preferred quit medications at no cost to the member
2 quit attempts per year
No prior authorization for preferred treatments
No co-pay
Up to $150 for participating
These services are available to eligible Medicaid members of any age who use tobacco, including e-cigarettes. Learn more about addressing the youth vaping epidemic.
New offer from 802Quits.
Medicaid members and uninsured Vermonters who want to quit tobacco can now earn up to $150 by enrolling in 802Quits. Refer patients for free counseling, quit medication and more.
Qualifying patients must be Vermont residents age 18 or older. Eligibility will be determined upon enrollment. Some conditions apply.
HOW TO ACCESS OR REFER
Begin referring and ask your coding and billing team to review these counseling codes to get reimbursed for using this method.
Coding and Billing
Use medical codes in your practice to capture the diagnosis for tobacco and bill smoking and tobacco cessation counseling.