Respiratory Question for the Week of February 17, 2020

Question:

Can respiratory therapists (RTs) perform smoking and tobacco-use cessation counseling services for Medicare patients? Since the RTs really don’t submit claims, can the hospital bill a technical component if the services are performed by an RT under physician order (i.e., under the Medicare incident-to policy)?

Answer:

According to the Centers for Medicare & Medicaid Services (CMS), Medicare Part B covers tobacco cessation counseling for outpatient and hospitalized Medicare beneficiaries whose counseling is furnished by a qualified physician or another Medicare-recognized practitioner. In the August 2010 decision memorandum, CMS stated the following in response to public comments requesting that others, including respiratory therapists, be covered:

CMS can only cover tobacco cessation counseling for outpatient and hospitalized Medicare beneficiaries furnished by a qualified physician or other Medicare-recognized practitioners. Certified tobacco cessation specialists, pharmacists, registered nurses, chemical dependency counselors, health educators, and respiratory therapists are not recognized in the law as qualified Medicare Part B practitioners for furnishing counseling services. In the case of pharmacists, these health professionals may qualify as durable medical equipment suppliers for Medicare.

This question was answered in our annual Respiratory Therapy Reimbursement & Compliance Update webcast. For more hot topics relating to respiratory services, please visit our store or call us at 1.800.252.1578, ext. 2.