Tobacco cessation counseling

Page last updated on: 6/16/25

Applies to:

All plans

Prevention of Tobacco and Nicotine Use Including Vaping

Tobacco cessation counseling billing

Priority Health will reimburse, fee for service, for tobacco cessation counseling codes. Reimbursement is available to primary care and specialty physicians.

Documentation requirements

  • Document the time spent with the patient involving smoking cessation counseling. 
  • Document what was discussed during this counseling session (plans to decrease smoking and/or steps to quit smoking)  
  • Documentation must support the code being billed.

    Examples of inadequate documentation

    These examples lack a) the exact time and b) what was discussed.

    • "Spent greater than 3 minutes counseling the patient on smoking."
    • "Spent between 3 to 10 minutes counseling the patient on smoking."
    • "Spent over 10 minutes counseling the patient on smoking."

    Reimbursement rates

    The reimbursement rates for these codes are listed in our standard fee schedules for your contract. See fee schedules.

    Billable codes

    The CPT and HCPCS manuals define billing and coding requirements for tobacco counseling codes. Codes should be billed with the appropriate ICD10 code identifying tobacco use.

    These codes can be billed by either the physician or a qualified health professional.

    Code Description Reimbursement
    99406Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutesPayable as a preventive benefit; no member copayment or deductible
    99407Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutesPayable as a preventive benefit; no member copayment or deductible
    4000FTobacco use cessation intervention, counseling (COPD, CAP, CAD, Asthma) (DM) (PV)CMS CPTII report only code; no reimbursement
    4001FTobacco use cessation intervention, pharmacologic therapy (COPD, CAD, CAP, PV, Asthma) (DM) (PV)CMS CPTII report only code; no reimbursement
    4004FPatient screened for tobacco use and received tobacco cessation intervention (counseling, pharmacotherapy, or both), if identified as a tobacco user (PV, CAD)CMS CPTII report only code; no reimbursement