Q&A: CAH billing for smoking cessation therapy

Wednesday, October 12, 2022

Q: We are a critical access hospital (CAH). We provide smoking cessation therapy (CPT codes 99406-99407) in our cardiac rehab department. The documentation is done and signed by a respiratory therapist (RT), and we are currently billing this as a professional charge (on a UB-04 with revenue code 0981). My question is, can we bill this on a UB-04 as a facility charge only and still allow our RT or other ancillary staff to perform it?

A: Yes, you can. See the Medicare Claims Processing Manual. If this is being done by RTs that cannot bill Method II, then you would bill on the CAH UB-04 and receive reimbursement at 101% of reasonable cost for Medicare.

Editor’s note: This question was answered on the NAHRI Forums. Opinions expressed are those of the authors and do not necessarily represent those of NAHRI, HCPro, or any of its subsidiaries. Find more NAHRI resources on CAH billing here.