MedicaidCoverageMedium impact
Tobacco Cessation Counseling Services and Pharmacotherapy for Pregnant and Post-Partum Women Age 21 and Over and Children through Age 20
Illinois Medicaid - HFS·IL · Family Medicine, General Practice, Internal Medicine +2 more·Provider Notice
Effective date
Jan 1, 2014
We identified it
Jun 20, 2026
Summary
Illinois Medicaid now covers tobacco cessation counseling services using CPT codes 99406 and 99407 for pregnant/postpartum women age 21+ (up to 12 sessions per year) and children through age 20 (unlimited sessions). Pharmacotherapy is also covered with prior authorization requirements.
Action Required
Immediately: Billing team must update system to allow separate billing of CPT 99406 and 99407 for tobacco cessation counseling for eligible Illinois Medicaid patients. Providers must document total time spent, discussion topics, cessation techniques, and resources provided with signature in medical record. Contact Bureau of Professional and Ancillary Services at 1-877-782-5565 for questions about prior authorization requirements for pharmacotherapy.