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  • Quit For Life Incentive Reimbursement Form

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Ard. The reward will be included in the subscriber s paycheck and will be taxed. 1. Name of Quit For Life Participant: Employee Spouse 2. Date of enrollment in Quit For Life 3. Date of completion of five live quit coaching calls 4. Date of completion of six-month survey administered by Quit For Life 5. Return this completed form via fax to 434.

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What codes are used to bill for these services? G0375—Smoking and tobacco-use cessation counseling visit; intermediate session of more than 3 minutes and up to 10 minutes. G0376—Smoking and tobacco-use cessation counseling visit; intensive session of more than 10 minutes.

Quitline can help you create a personalised quit smoking plan. They also provide a way for you to get free nicotine patches, gum and lozenges from your local pharmacy. They offer phone, text, online and face to face support to quit smoking.

Use CPT® code 99406 and CPT® code 99407 for symptomatic or asymptomatic patients, for a tobacco cessation counseling visit. Document the time of the counseling spent face-to-face with the patient discussing smoking and smoking cessation. Add a diagnosis code (or codes) that describes the adverse effects of tobacco.

Billing, coding and documentation guidance CPT® CodeDescriptor2022 Medicare Non-Facility Payment 99406 Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes $15.57 99407 Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes $28.721 more row • Sep 9, 2022

All FDA-approved tobacco cessation medications are covered with a doctor's prescription, including combination nicotine replacement therapy. For more information contact your health plan or consult your plan's brochure.

Medi-Cal Managed Care plans may offer additional tobacco cessation services. Medi-Cal members who smoke have a great new reason to quit! Free nicotine replacement patches and $20 gift card now available for calling the California Smokers' Helpline at 1-800-NO-BUTTS and developing a “quit smoking” plan.

All FDA-approved tobacco cessation medications are covered with a doctor's prescription, including combination nicotine replacement therapy. For more information contact your health plan or consult your plan's brochure.

Freedom From Smoking® is ranked one of the most effective cessation programs in the country, as it is available in a variety of formats and includes a comprehensive variety of evidence-based, proven-effective cessation techniques.

NRT is available to everyone free from your community pharmacy, stop smoking adviser or GP. This will also give you access to additional support through your prescriber. Medication and support will increase your chances of stopping and staying stopped.

Some states have special programs for people who smoke and don't have health insurance. They may also be able to provide you with free medicines directly, for example by sending some nicotine patches, lozenges, or gum to your home.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232