National Coverage Analysis (NCA) Tracking Sheet

Smoking & Tobacco Use Cessation Counseling

CAG-00241N

Issue

The Centers for Medicare & Medicaid Services (CMS) received a formal request from Partnership for Prevention, asking that we issue a national coverage determination (NCD) on tobacco cessation counseling for the treatment of individuals who use tobacco and have been diagnosed with a recognized tobacco-related disease or who exhibit symptoms consistent with tobacco-related disease. Specifically, the request calls for coverage for eligible individuals of (1) brief counseling at every patient encounter, (2) a stand-alone cessation visit, and (3) intensive counseling (for those willing to try) for a least two cessation attempts per year. At present, there is no NCD or national coverage policy that has been issued by CMS on these types of services. In the absence of a NCD or national coverage policy on the subject, however, local Medicare contractors have the discretion to cover these services when they determine them to be medically necessary for the individual patient.

Benefit Category

Clinical Social Worker Services
Incident to a physician's professional Service
Outpatient Hospital Services Incident to a Physician's Service
Physicians' Services
Qualified Psychologist Services
Rural Health Clinic Services

Requestor Information

Requestor Name Requestor Letter
Mr. John M. Clymer, President, Partnership for Prevention View Letter
N/A

Important Dates

Formal Request Accepted and Review Initiated
06/23/2004
Expected NCA Completion Date
03/21/2005
Public Comment Period
06/23/2004 - 07/23/2004
Proposed Decision Memo Due Date
Proposed Decision Memo Released
12/23/2004
Proposed Decision Memo Public Comment Period
12/23/2004 - 01/21/2005
Decision Memo Released
03/22/2005
Comments for this NCA
View Public Comments

Contacts

Lead Analysts
William Larson
Lead Medical Officers
Jyme Schafer, MD, MPH

Medicare Benefit Category Determination Date

Actions Taken

June 23, 2004

NCD opened and request letter posted.

August 11, 2004

Comments [PDF, 422KB] from the 30-day public coment period are now available for viewing.

December 23, 2004

CMS is posting a Proposed Decision Memorandum  for a 30-day public comment period. CMS is particularly interested in comments on the following:
  • Coverage of intermediate and intensive counseling,
  • Training requirement, and
  • CMS decision.
Instructions for submitting public comments are available at http://www.cms.hhs.gov/coverage/8h.asp

March 22, 2005