MEDICAID TOBACCO CESSATION BENEFITS

In Vermont, low-income or disabled individuals up to 138 percent of the federal poverty level are covered by Medicaid and qualify for tobacco cessation as a preventive service. This includes:

16 face-to-face smoking cessation counseling sessions per year with an authorized health care professional

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

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.