Medicare (CMS) Now Medicare (CMS) Now Covers Smoking and Covers Smoking and

Tobacco-Use Cessation Tobacco-Use Cessation CounselingCounseling

2005 National Primary Oral 2005 National Primary Oral Health Care ConferenceHealth Care Conference

August 8, 2005August 8, 2005Atlanta, GAAtlanta, GA

Reality CheckReality Check

Tobacco use is the leading cause of Tobacco use is the leading cause of preventable death in the U.S.preventable death in the U.S.

9.3 percent of those aged 65 and 9.3 percent of those aged 65 and older smoke cigarettesolder smoke cigarettes

Substantial cost to the healthcare Substantial cost to the healthcare systemsystem

Reduction in smoking prevalence is a Reduction in smoking prevalence is a national objectivenational objective

Brief HistoryBrief History

Partnership for Prevention made Partnership for Prevention made request to CMS for a National request to CMS for a National Coverage Determination (NCD)Coverage Determination (NCD)

NCD made effective 3/22/05 NCD made effective 3/22/05 www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=130www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=130

The BenefitThe Benefit

Intermediate and intensive smoking Intermediate and intensive smoking cessation counseling servicescessation counseling services

Two cessation attempts/yearTwo cessation attempts/yearFour face-to-face sessions per Four face-to-face sessions per

attemptattemptChoose intermediate or intensiveChoose intermediate or intensive

Intermediate vs. IntensiveIntermediate vs. Intensive

G0375- Intermediate cessation visit: G0375- Intermediate cessation visit: greater than 3 minutes up to 10 minutesgreater than 3 minutes up to 10 minutes

G0376-Intensive cessation visit: greater G0376-Intensive cessation visit: greater than 10 minutesthan 10 minutes

See alsoSee also

The Public Health Service 2000 The Public Health Service 2000 Clinical Practice Guideline. Treating Clinical Practice Guideline. Treating Tobacco Use and DependenceTobacco Use and Dependence

http://www.surgeongeneral.gov/http://www.surgeongeneral.gov/

tobacco/treating_tobacco_use.pdftobacco/treating_tobacco_use.pdf

The PatientThe Patient

Is alert and competentIs alert and competentSuffers from disease/condition linked Suffers from disease/condition linked

to tobacco use ORto tobacco use OR Is using a therapeutic agent whose Is using a therapeutic agent whose

metabolism or dosing is affected by metabolism or dosing is affected by tobacco use as based on FDA-tobacco use as based on FDA-approved information approved information

The ProviderThe Provider

Is a qualified physician or other Is a qualified physician or other Medicare recognized practitioner Medicare recognized practitioner including a dentist . . .including a dentist . . .

As long as he is practicing within his As long as he is practicing within his scope according to the Statescope according to the State

Toolkit for Healthcare Professionals: Toolkit for Healthcare Professionals: Medicare Prescription Drug CoverageMedicare Prescription Drug Coverage

Go to:Go to:

www.cms.hhs.gov/medlearn/www.cms.hhs.gov/medlearn/drugcoverage.aspdrugcoverage.asp

to access the toolkit and other educational to access the toolkit and other educational resourcesresources

National Provider Identifier National Provider Identifier (NPI)(NPI)

Apply now for your NPIApply now for your NPI

The NPI replaces the current health The NPI replaces the current health care provider identifiers care provider identifiers

For additional information and the For additional information and the application go to application go to https://nppes.cms.hhs.gov https://nppes.cms.hhs.gov

ContactsContacts United Government ServicesUnited Government Services Toll Free 1-877-309-4290Toll Free 1-877-309-4290 http://www.ugsmedicare.comhttp://www.ugsmedicare.com

CMS Regional Offices or Part B CarriersCMS Regional Offices or Part B Carriers http://www.cms.hhs.gov/contacts/http://www.cms.hhs.gov/contacts/

Lana DennisLana Dennis Atlanta Regional CMS OfficeAtlanta Regional CMS Office 404/562-7379404/562-7379 Lana.Dennis@cms.hhs.govLana.Dennis@cms.hhs.gov

Thank You Thank You

Any Questions?Any Questions?