Respiratory Question for the Week of May 22, 2017

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 a spokesperson from 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 other Medicare-recognized practitioner (NP, PA, CNS).

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….

For the above, go to https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=242).