Respiratory Question for the Week of February 17, 2025

Question:

When billing Medicare for smoking and tobacco-use cessation counseling, how should providers track the 12-month limit of eight sessions to ensure compliance?

Answer:

Medicare payers have been instructed to only pay for eight smoking and tobacco-use cessation counseling sessions in a 12-month period. The beneficiary may receive additional sessions in a subsequent year, but a minimum of 11 full months must have passed since the first covered session was performed. To start the count for the second or subsequent 12-month period, begin with the month after the month in which the first Medicare-covered cessation session was performed and count until 11 full months have elapsed.

This question was answered in our Coding Essentials for RT/Pulmonary Function. For more hot topics relating to respiratory services, please visit our store or call us at 1.800.252.1578, ext. 2.