Quit Tobacco Series Fact Sheet #14: Private-Payer Codes


Private-payer benefits are subject to specific plan policies. Before providing service, benefit-eligibility and payer-coding requirements should be verified.


Billing Codes

  • CPT 99406: Intermediate smoking & tobacco-use cessation counseling visit (more than 3 minutes, up to 10 minutes)
  • CPT 99407: Intensive smoking & tobacco-use cessation counseling visit (more than 10 minutes)

Diagnostic Code

ICD-10: Tobacco-use disorder


According to the U.S. Department of Health and Human Services:

1) The combination of counseling and medication to quit smoking is more effective than either alone.

2) Counseling for just 3 minutes can increase the rate of abstinence.

 

WI Medicaid / BadgerCare+ Codes

Before providing service, benefit-eligibility and payer-coding requirements should be verified.


Billing Codes

  • CPT 99201-99205: New patients
  • CPT 99211-99215:  Established patients

Sub-Increments

Intermediate smoking and tobacco-use cessation counseling visit (more than 3 minutes, up to 10 minutes)

Intensive smoking and tobacco-use cessation counseling visit (more than 10 minutes)


Diagnostic Code

ICD-10: Tobacco-use disorder