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PDFWAC 182-531-1720

Tobacco/nicotine cessation counseling.

(1) The medicaid agency covers tobacco/nicotine cessation counseling when:
(a) Delivered by qualified providers through an agency-approved tobacco/nicotine cessation telephone counseling service;
(b) The client is pregnant or in the postpartum period as defined in 42 C.F.R. 435.170. The agency pays for face-to-face office visits for tobacco/nicotine cessation counseling for these clients with the following limits:
(i) Counseling must be provided by qualified physicians, advanced registered nurse practitioners (ARNPs), physician assistants-certified (PA-Cs), naturopathic physicians, pharmacists, certified nurse-midwives (CNM), licensed midwives (LM), psychologists, or dentists;
(ii) Two tobacco/nicotine cessation counseling attempts are allowed every twelve months. An attempt is defined as up to four tobacco/nicotine cessation counseling sessions; and
(iii) The agency does not cover more than one face-to-face tobacco/nicotine cessation counseling session per client, per day. The provider must keep written documentation in the client's record for each session.
(c) Provided through screening, brief intervention, and referral to treatment (SBIRT). To receive payment for tobacco/nicotine cessation counseling through SBIRT, providers must bill the agency using the agency's published billing instructions.
(2) A provider may prescribe pharmacotherapy for tobacco/nicotine cessation when the provider considers the treatment appropriate for the client. The agency covers certain pharmacotherapy for tobacco/nicotine cessation, including prescription drugs and over-the-counter (OTC) nicotine replacement therapy (NRT), as described in chapter 182-530 WAC.
[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 19-22-017, § 182-531-1720, filed 10/25/19, effective 11/25/19; WSR 15-03-041, § 182-531-1720, filed 1/12/15, effective 2/12/15.]
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