Does Medicare cover CPT code 99406?
Smoking Cessation Counseling Codes 99406 and 99407 Medicare covers 2 cessation attempts per 12-month period. Each attempt includes a maximum of up to 4 intermediate (99406) or intensive (99407) counseling sessions, with a total Medicare benefit of 8 sessions per year.
What is a 99406?
Basics of CPT code 99406 & 99407 CPT code 99406 is used to report for smoking and tobacco cessation counseling requiring three to 10 minutes of time and CPT code 99407 for counseling requiring more than ten minutes. Read also: Alcohol use, Abuse and nicotine dependence ICD 10 coding guide.
Does CPT 99406 require a modifier?
Magnolia Health (MH) indicates that 99406 and 99407 are reimbursed with no modifier or diagnosis limitations. The codes are payable on the physician side, but are not covered for outpatient facility claims.
How often can 99406 be billed?
The 2019 CMS guidelines state that Medicare covers two cessation attempts per 12-month period. Each attempt includes a maximum of up to four intermediate (99406) or intensive (99407) counseling sessions, with a total Medicare benefit of eight sessions per year.
Can 99406 be billed inpatient?
CPT code 99406, 99407 , C9801, C9802 – Tobacco Use Cessation Counseling. Medicare covers counseling for tobacco cessation for outpatients and for inpatients. Inpatients are covered only if counseling for tobacco use is not the primary reason for the patient’s hospital stay. Medicare covers 2 cessation attempts per year …
How much does Medicare reimburse for 99406?
Medicare’s average reimbursement for 99407, smoking cessation for longer than 10 minutes of counseling, is $27.93. The 10-minute-or-longer consult may not apply to everyone. The 3-to-10-minute counseling code, 99406, reimburses at an average of $14.32.
Can you bill 99406 with G0439?
In addition, the following services can also now be billed when using audio only: Advance Care Planning (CPT 99497, 99498) Annual Wellness Visits (HCPCS G0438, G0439) Smoking Cessation Services (CPT 99406, 99407)
Can 90471 and 99406 be billed together?
If you check the CCI edits, you’ll see that 99406 is a Column 2 code when billed with 90471. You need either a -59 modifer OR one of the X{EPSU} modifiers on 99406 if it is supported by the documentation as a separate service.
How often can CPT 99406 be billed?
A total of eight sessions are covered in a 12-month period. However, these limits do not apply to Paramount members as they are allowed an unlimited number of visits. Smoking cessation (99406 and 99407) services were developed as E/M services and may be reported with the E/M services 99201-99205 and 99211-99215.