Per NGS, coverage for tobacco cessation counseling for outpatient and hospitalized Medicare beneficiaries include those:
who use tobacco, regardless if they have signs or symptoms of tobacco-related disease,
who are competent and alert at the time counseling is provided, and
whose counseling is furnished by a qualified physician or other Medicare-recognized provider. Medicare covers two individual tobacco cessation counseling attempts per year.
Each attempt may include a maximum of four intermediate or intensive sessions, with a total benefit covering up to eight sessions per year in a twelve-month period:
99406: Intermediate – more than three minutes, up to ten minutes.
99407: Intensive – more than ten minutes.
To start the count for the second or subsequent twelve-month period, begin with the month after the month the first Medicare-covered counseling session was performed and count until eleven full months have elapsed.
