CPT code G0436, G0437 – DX 305.1, v15.82

Counseling to Prevent Tobacco Use

This is a new benefit beginning for dates of service on and after 08/25/10

CPT code G0436 – Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes

CPT code G0437 – Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes

Report one of the following DX codes:
305.1 or V15.82

Outpatient and hospitalized beneficiaries who use tobacco, regardless of whether they have signs or symptoms of tobacco-related disease; are competent and alert at the time that counseling is provided; and whose counseling is furnished by a qualified physician or other Medicare-recognized practitioner

2 cessation attempts per year;

Each attempt includes maximum of 4 intermediate or intensive sessions; up to 8 sessions in a 12-month period

Medicare payment 
Prior to 01/01/11:
• Copayment/coinsurance applies
• Deductible applies
On or after 01/01/11:
• Copayment/coinsurance waived
• Deductible waived