MedicaidCoverageMedium impact
BT2022100: IHCP updates guidance for tobacco dependence individual and group counseling sessions
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, General Practice +4 more·Provider Bulletin
Effective date
Dec 15, 2022
We identified it
Jun 19, 2026
Summary
IHCP (Indiana Medicaid) has updated its tobacco dependence counseling policy effective December 15, 2022, adding specific criteria for individual and group counseling sessions. The policy clarifies billing requirements for CPT codes 99406, 99407 and CDT code D1320, with group sessions requiring modifier HQ and limited to 8 participants maximum.
Action Required
By December 15, 2022: Billing team must update system to ensure tobacco dependence counseling claims use CPT 99406 or 99407 (with modifier HQ for group sessions of max 8 participants) or CDT D1320 for dentists only. Providers must document the 5 A's approach (Ask, Advise, Assess, Assist, Arrange), health screening, and maintain records. Update encounter forms to remind providers that counseling must be prescribed by licensed practitioners and include required assessment components.