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Does anyone know if you can bill Medicaid for counseling or for CO2 testing in a smoking cessation program? I noticed on the website for the smoking cessation program materials that we will purchase shares the CPT codes. Thanks! Paula
You can bill Medicaid, the real question is will they pay for it. If you can share the CPT codes, I can look at the fee schedule to see if it is a reimbursable code.
CPT 94250 for the test and 99406 and 99407 for the counseling. I forget about the fee schedules! Thanks.
Paula, what program are you going with? We are looking for one to use. And would also like to know if we can bill and be paid. That would be great
It is CoVita. Martha said we couldn’t do Baby and me Tobacco Free because we would be spending too much as a subcontractor(?).
Sharon said: 99406 & 99407 specifically say they have to be counseling by a physician or other qualified health professional. So I would make sure you medical director is ok with the counseling that is being provided and being billed, because you will more than likely have to use their NPI # in order to get paid.
94250 is the actually testing, so again as long as you have orders to do these and your medical director is good with it. You should be able to bill and be reimbursed.
I checked with the MO Medicaid Provider unit and received the following response.
As long as the smoking cessation protocol/procedures are documented in your standing orders and signed off on by your medical director, an RN can perform the smoking cessation protocol and covered behavioral interventions. See the Smoking Cessation bulletin for more information. https://dss.mo.gov/mhd/providers/pdf/bulletin38-02_2015jul15.pdf
You will bill, as you usually do, with the billing provider as the County Health Clinic and your medical director as the performing provider.
Please feel free to contact me in Provider Education if you have further questions or if I can be of additional assistance.
Dana Bernier
Constituent Services Unit
Provider Education Representative
Mo HealthNet Division
573-751-6683All, I checked with the MO Medicaid Provider unit and received the following response. We use the Covita CO monitors with the SCRIPT cessation program.
As long as the smoking cessation protocol/procedures are documented in your standing orders and signed off on by your medical director, an RN can perform the smoking cessation protocol and covered behavioral interventions. See the Smoking Cessation bulletin for more information. https://dss.mo.gov/mhd/providers/pdf/bulletin38-02_2015jul15.pdf
You will bill, as you usually do, with the billing provider as the County Health Clinic and your medical director as the performing provider.
Please feel free to contact me in Provider Education if you have further questions or if I can be of additional assistance.
Dana Bernier
Constituent Services Unit
Provider Education Representative
Mo HealthNet Division
573-751-6683
I checked with the MO Medicaid Provider unit and received the following response.
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