Part B Coding Coach: Circumvent Smoking Cessation Coding Concerns With This Primer

Why This Topic Matters

Smoking cessation counseling is a common preventive service, but reimbursement depends on coverage rules, documentation, timing, and place-of-service or telehealth circumstances. Understanding the article helps readers assess whether the service is billable and what general policy areas need review before claim submission.

Article Sections

1. Understand Cessation Counseling Eligibility

   This section covers Medicare Part B coverage context for tobacco cessation counseling and the general eligibility considerations discussed in CMS guidance. It also notes the role of payer policy differences and references CMS coverage resources.

2. Recognize the Differences Between 99406 and 99407

   This section addresses the article’s discussion of time-based reporting distinctions, related evaluation and management considerations, documentation expectations, and when additional reporting elements may be involved. It also references Medicare-recognized practitioners and CPT documentation guidance.

3. Know How Many Sessions to Report Per Year

   This section covers the annual session limitation discussed in the article, along with the Medicare systems and manual guidance used to verify or understand beneficiary eligibility across coverage periods. It also mentions payer variation.

4. Report Modifier 93 for Over-the-Phone Sessions

   This section reviews the article’s discussion of audio-only telehealth billing for cessation counseling and the related CPT telemedicine guidance. It includes the article’s references to updated CPT materials and telemedicine appendix guidance.