This designates services that are confidential between the health care provider and the patient. These confidential services are appropriate for billing IF your client is enrolled in Medicaid or a Medicaid Health Plan. If your client has Commercial insurance – consider billing only for the non-confidential services that you provided.
The current Medicaid Health plans in the state are:
- Blue Cross Complete of Michigan
- Coventry Cares
- HAP Midwest Health Plan
- Harbor Health Plan
- HealthPlus Partners
- McLaren Health Plan
- Meridian Health Plan
- Molina Healthcare of Michigan
- Priority Health Choice
- Sparrow PHP
- Total Health Care
- United Healthcare Community Plan
- Upper Peninsula Health Plan
Tracking Smokers for Quality Improvement Purposes
- Use ICD-9 Diagnoses code 305.1 (Tobacco use disorder) or 649.0x if you are working with a pregnant mom
- Use CPT Codes 99406/99407 for Counseling. 99406 is Intermediate type of counseling that is greater than 3 minutes but not more than 10 minutes. 99407 is Intensive counseling that is greater than 10 minutes. Current Michigan Medicaid fee schedule for 99406 pays $6.93 and 99407 pays $14.26.
- When billing commercial insurers, various E/M services (associated with acute or chronic care) may be coded. When providing an E/M service, if greater than 50% of face-to-face time with patient is spent on counseling, time may be used as a basis for selection of level of service.
- As of January 1, 2014 all state Medicaid programs are required to support all FDA-approved smoking cessation medications WITHOUT requiring co-pays or other financial barriers.