UM Guidelines
Smoking Cessation

Ambulatory Care (AC)

BCBST last reviewed September 14, 2023*

Added: Clinical Indications for Counseling:
   
  • Counseling to prevent tobacco use may be covered for ALL of the following:
    • Uses tobacco, regardless of whether he or she has signs or symptoms of tobacco-related disease
    • Is competent and alert at time that counseling is provided
    • Counseling is furnished by qualified physician or practitioner
    • Services are appropriate for 2 individual attempts per 12-month period [A] session attempts per year
 

References

  1. BlueCross BlueShield of Tennessee network physicians. July - September 2023.

  2. Centers for Medicare & Medicaid Services. CMS.gov. NCD for smoking and tobacco-use cessation counseling (210.4.1). Retrieved July 17, 2023 from https://www.cms.gov.

Footnotes

[A] Each attempt may include a maximum of 4 intermediate or intensive sessions, with a total of up to 8 sessions per 12-month period. The practitioner and patient have the flexibility to choose between intermediate (more than 3 minutes but less than 10 minutes), or intensive (more than 10 minutes) cessation counseling sessions for each attempt.

 

 
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