"Medicaid Expands Coverage for Smoking Cessation Counseling (SCC) by Dental Practitioners
The NYS Department of Health (DOH) has prioritized tobacco cessation as a public health initiative. DOH now is including coverage for smoking cessation counseling (SCC) for Medicaid patients by dental practitioners.
Coverage for SCC in Medicaid became effective on April 1 in the fee-for-service Medicaid program and on July 1 for the Medicaid managed care program. To be eligible for reimbursement, claims for SCC must meet very specific criteria. Dental practitioners will be allowed to provide two smoking cessation counseling sessions to a Medicaid beneficiary within any 12 continuous months.
According to DOH, reimbursement to office-based dental practitioners will be at the rate of $10.00 per visit. NYSDA advises dentists who provide treatment to Medicaid recipients enrolled in managed care to review their contracts to determine how this change affects their reimbursement and whether any changes need to be made to their participating provider contracts. For additional information, please see the May 2014 Medicaid Update. The Medicaid Update is available online at www.health.ny.gov.