Medicaid Behavioral Health Services: Smoking and Tobacco Use Cessation Counseling (Excluding Mandatory Coverage for Pregnant Women)

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2022

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 39; No - 6; NR - 6	Yes - 3	Yes - 3
Alabama	Yes	Yes - not specified	No
Alaska	Yes	NR	NR
Arizona	Yes	NR	No
Arkansas	NR	NR	NR
California	Yes	No	No
Colorado	Yes	No	No
Connecticut	Yes	No	No
Delaware	NR	NR	NR
District of Columbia	Yes	No	No
Florida	No
Georgia	NR	NR	NR
Hawaii	Yes	No	No
Idaho	Yes	No	No
Illinois	No
Indiana	Yes	No	NR
Iowa	Yes	No	No
Kansas	Yes	No	No
Kentucky	Yes	No	NR
Louisiana	Yes	NR	NR
Maine	Yes	No	No
Maryland	Yes	No	NR
Massachusetts	Yes	Yes - not specified	No
Michigan	Yes	No	No
Minnesota	NR	NR	NR
Mississippi	No
Missouri	Yes	No	No
Montana	Yes	No	No
Nebraska	Yes	No	Limit of 2 episodes of care per year
Nevada	Yes	No	NR
New Hampshire	NR	NR	NR
New Jersey	Yes	No	No
New Mexico	Yes	No	No
New York	Yes	No	No
North Carolina	Yes	No	NR
North Dakota	Yes	No	No
Ohio	Yes	No	No
Oklahoma	Yes	No	NR
Oregon	Yes	No	NR
Pennsylvania	Yes	No	No
Rhode Island	Yes	No	No
South Carolina	No
South Dakota	Yes	$1 pharmacy copay for generic and $3.30 for brand-name	No
Tennessee	Yes	No	No
Texas	No
Utah	NR	NR	NR
Vermont	Yes	No	Prior authorization is required if visits exceed 16 per year
Virginia	No
Washington	Yes	No	No
West Virginia	Yes	No	Based on medical necessity
Wisconsin	Yes	No	NR
Wyoming	Yes	No	No

2018

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 37 No - 9 NR - 5	Yes - 4	Yes - 10
Alabama	No
Alaska	Yes	No	No
Arizona	Yes	No	No
Arkansas	Yes	NR	NR
California	Yes	No	No
Colorado	Yes	No	No
Connecticut	Yes	No	When billing for individual smoking cessation counseling codes (99406, 99407), claims for a HUSKY A, C, or D member require a nicotine dependency primary diagnosis code (i.e. F17.20- F17.299, Nicotine dependence).
Delaware	Yes	No	No
District of Columbia	Yes	No	No
Florida	No
Georgia	Yes	No	No
Hawaii	Yes	No	No
Idaho	Yes	No	Limited to Pregnant Women.
Illinois	NR	NR	NR
Indiana	Yes	No	Age limits apply. A minimum of 30 minutes (two units) and a maximum of 150 minutes (10 units) per member per calendar year. Providers must bill counseling in 15-minute increments.
Iowa	NR	NR	NR
Kansas	Yes	No	No
Kentucky	Yes	Co Pay $3	No
Louisiana	No
Maine	Yes	No	No
Maryland	Yes	No	Services are pre-authorized
Massachusetts	Yes	No	No
Michigan	Yes	No	No
Minnesota	Yes	No	NR
Mississippi	No
Missouri	Yes	No	No
Montana	Yes	No	No
Nebraska	Yes	No	Two episodes of care per year. A session includes a 90 day supply of medication and up to 4 counseling sessions
Nevada	Yes	No	Yes - Not Specified
New Hampshire	NR	NR	NR
New Jersey	Yes	No	No
New Mexico	No
New York	NR	NR	NR
North Carolina	Yes	No	Limited to physician codes for smoking cessation counseling (99406 and 99407)
North Dakota	No
Ohio	Yes	No	No
Oklahoma	Yes	No	NR
Oregon	Yes	No	No
Pennsylvania	Yes	No	Medical necessity
Rhode Island	Yes	No	No
South Carolina	NR	NR	NR
South Dakota	No
Tennessee	Yes	No	No
Texas	No
Utah	Yes	$4 for each prescription	24 weeks maximum per year for Chantix
Vermont	Yes	No	NR
Virginia	No
Washington	Yes	No	No
West Virginia	Yes	No	No
Wisconsin	Yes	$0.50-$3.00 per service	No
Wyoming	Yes	$2.45 for non - emergent	Prior authorization is required after the first 12 visits to confirm ongoing medical necessity

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Medicaid Behavioral Health Services: Smoking and Tobacco Use Cessation Counseling (Excluding Mandatory Coverage for Pregnant Women)

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Medicaid Behavioral Health Services: Smoking and Tobacco Use Cessation Counseling (Excluding Mandatory Coverage for Pregnant Women)

2022

2018

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