In This Issue:

HIP Service Area Expansion Affects GHI HMO Providers

New Prior Approval List

New Web Usage Requirements for GHI HMO Network Providers

New EmblemHealth Radiation Therapy Program and EmblemHealth Cardiology Imaging Program and HIP Radiology Programs Apply to More Members

Updated Fax Forms for: EmblemHealth Injectable Drug Utilization Management Program

EmblemHealth Consolidates Post Office Boxes for GHI HMO and EmblemHealth Medicare PPO

Claims Corner

Medicaid and Medicare Updates

Behind the Scenes

Case Management Programs

Stressing the Importance of Prenatal Visits

Well-Child Visits

High-Risk Medications for Elderly Patients

Healthful Aging Starts With Lifestyle Changes and Preventive Screenings

Talking With Patients About Urinary Incontinence

Treating Rheumatoid Arthritis

Assisting Patients Living With HIV

Treating Low Back Pain

Asthma Management

CPT Codes for Tobacco Cessation Counseling

Clinical Corner

News&Notes Archive

CPT Codes for Tobacco Cessation Counseling

EmblemHealth partners with the New York State Smokers' Quitline to provide comprehensive tobacco cessation services to our members. When you identify patients ready to quit smoking, you can refer them to the Quitline at 1-866-NY-QUITS (1-866-697-8487).

US Public Health Service clinical practice guidelines recommend that practitioners cover the Five A's during all patient visits. We encourage you to incorporate these 5A's into your practice:

  • Ask all of your patients if they smoke.
  • Advise every smoker to quit smoking.
  • Assess their readiness to quit.
  • Assist with a plan for quitting.
  • Arrange for follow-up.

Studies show that a follow-up visit or phone call within one week of the patientís quit date can double the effectiveness of any intervention. We provide reimbursement for tobacco cessation counseling based on current Centers for Medicare and Medicaid Services (CMS) guidelines. Please use the following CPT codes for these office visits:

  • 99406 Smoking and tobacco-use cessation counseling visit, intermediate, greater than three minutes up to 10 minutes
  • 99407 Smoking and tobacco-use cessation counseling visit, intensive, greater than 10 minutes.


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