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Tobacco cessation counseling for pregnant women

Effective March 1, 2014 Mississippi Division of Medicaid began coverage for tobacco cessation counseling for pregnant women according to the following criteria: Tobacco cessation counseling services must be provided face-to-face and performed (by):

(i) Under supervision of a physician; OR

(ii) Any other health care professional who is legally authorized to furnish such services under State
law and who is authorized to provide Medicaid coverable services other than tobacco cessation
services; OR

(iii) Any other health care professional legally authorized to provide tobacco cessation services
under State law and who is specifically designated by the Secretary in regulations.

Services are ONLY available for Medicaid-eligible pregnant females who smoke.  Face-to-Face tobacco cessation counseling services for pregnant women are limited to one counseling session per quit attempt with mandatory referral to the MS Tobacco Quitline.

The following CPT codes are open for coverage effective March 1, 2014:

Code General Fee Site Differential Fee
99406 $11.57 $9.97
99407 $22.65 $21.32

Claims must include a diagnosis code from the following list based on the date of service:

For dates of service through Sept. 30, 2014 (ICD-9-CM) –
649.03- Tobacco use complicating pregnancy

For dates of service beginning Oct. 1, 2014 (ICD-10-CM) –
O99.331 – Smoking (tobacco) complicating pregnancy, first trimester
O99.332 – Smoking (tobacco) complicating pregnancy, second trimester
O99.333 – Smoking (tobacco) complicating pregnancy, third trimester

Information on providing Tobacco Cessation Medications can be found in the Administrative Code, Part 200, Chapter 5: General, Rule 5.4: Tobacco Cessation.

Please contact your Provider Representative or the Division of Medicaid if you have further questions.