MedicaidCoverageMedium impact
Clarification of Tobacco Cessation Copayment Policy
Wisconsin Medicaid (ForwardHealth)·WI · Family Medicine, General Practice, Internal Medicine +1 more·Medical Policy
Effective date
Sep 1, 2018
We identified it
Jun 20, 2026
Summary
ForwardHealth clarifies that BadgerCare Plus and Medicaid members do not require copayments for tobacco cessation counseling services and products, and no prior authorization is needed for services within approved diagnoses. SeniorCare members are still subject to copayments.
Action Required
Immediately: Billing team must update system to remove copayment requirements for tobacco cessation services and products for BadgerCare Plus and Medicaid members only. Ensure SeniorCare members continue to be charged copayments. Update billing software to not require prior authorization for tobacco cessation counseling within approved diagnoses. Verify prescriptions include appropriate diagnosis codes to avoid prior auth requirements.