Counseling to Prevent Tobacco Use A/B MAC (B) Billing Requirements

12.2 - Counseling to Prevent Tobacco Use A/B MAC (B) Billing Requirements (Rev.3848, Issued: 08- 25-17, Effective: 09-26-17, Implementation: 09- 26-17) A/B MACs (B) shall pay for counseling to prevent tobacco use services billed with codes 99406 and 99407 for dates of service on or after October 1, 2016 A/B MACs (B) shall pay for counseling services billed with codes G0436 and G0437 for dates of service on and after August 25, 2010, through September 30, 2016. The type of service (TOS) for each of the new codes is 1. A/B MACs (B) pay for these services billed based on the Medicare Physician Fee Schedule (MPFS). Deductible and coinsurance are waived. Claims from physicians or other providers where assignment was not taken are subject to the Medicare limiting charge, which means that charges to the beneficiary may be no more than 115% of the allowed amount. Physicians or qualified non-physician practitioners shall bill the A/B MAC (B) for counseling to prevent tobacco use services using the ASC X12 837 professional claim format or the Form CMS-1500.