CMS Pub. 100-04, ch. 18, § 150.2

A/B MACs (B) shall pay for counseling to prevent tobacco use services billed with code G0436 or G0437 for

dates of service on or after January 1, 2011. A/B MACs (B) shall pay for counseling services billed with code

99199 for dates of service performed on or after August 25, 2010 through December 31, 2010. The type of service

(TOS) for each of the new codes is 1.

A/B MACs (B) pay for counseling services billed based on the Medicare Physician Fee Schedule (MPFS).

Deductible and coinsurance apply for services performed on August 25, 2010, through December 31, 2010. For

claims with dates of service on and after January 1, 2011, coinsurance and deductible do not apply on G0436 and

G0437.

Physicians or qualified non-physician practitioners shall bill the A/B MACs (B) for counseling to prevent tobacco

use services on Form CMS-1500 or an approved electronic format.

NOTE: The above G codes will not be active in MACs’ systems until January 1, 2011. Therefore, MACs shall

advise providers to use unlisted code 99199 to bill for counseling to prevent tobacco use services during the

interim period of August 25, 2010, through December 31, 2010.

NOTE: Effective September 30, 2016, HCPCS codes G0436 and G0437 are no longer valid. The services

previously represented by G0436 and G0437 should be billed under existing CPT codes 99406 (Smoking and

tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes) or 99407 (Smoking

and tobacco use cessation counseling visit; intensive, greater 10 minutes) respectively.