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Medicaid Tobacco Cessation Program

Tobacco cessation medication and/or nicotine replacement therapy is available to Kentucky Medicaid members who use tobacco products. Dual-eligible members may be eligible to receive some of the available medicines to help them quit using tobacco. Members enrolled in a managed care organization (Anthem, CoventryCares of Kentucky, Humana Caresource, Passport Health Plan or WellCare of Kentucky) should contact that organization for the details of their tobacco cessation programs.

What is the process?

A prescription is needed for all tobacco cessation medications, including over-the-counter nicotine replacement products. No copayment is required for these medications. Some products are not preferred and will require review via the prior authorization process.

Tobacco cessation assessment takes a minimum of 10 minutes, is performed face to face and must include: asking the patient about tobacco use; advising the patient to quit; and assessing the patient's readiness to quit. If the assessed member's readiness to quit occurs during a regular office visit, the tobacco cessation counseling can be billed separately using CPT Code 99407. The assessment must include history of tobacco use, medical and psychosocial history, review of coping skills and barriers to quitting.

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Where do I go for more information?

For more information, call Kentucky Medicaid at (800) 635-2570. If you are assigned to Anthem, CoventryCares of Kentucky, Humana CareSource, Passport Health Plan or WellCare of Kentucky, call the number on the back of your membership card to find out about their tobacco cessation program.

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  907 KAR 3:125

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Last Updated 6/18/2014
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