Medicare proposes 19% pay bump for smoking cessation counseling
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- Centers for Medicare and Medicaid Services proposed a 19% increase in reimbursement for physicians who deliver tobacco cessation counseling, alcohol screening, and substance misuse interventions during patient visits, as part of a physician fee schedule update.
- American Lung Association's Anne DiGiulio called the proposed valuation of cessation services 'long overdue' and expressed strong support for the change, which she said prioritizes evidence-based preventive care.
- Ned Sharpless, former director of the National Cancer Institute, said the reimbursement bump would have 'tremendous implications' beyond Medicare because private insurers often follow federal payment policies.
- Adam Goldstein, a tobacco intervention expert at UNC School of Medicine, said most smokers only hear a brief 'You should quit' from doctors and urged pairing the payment change with system-wide supports like EHR prompts and tobacco-treatment specialists.
- Tim Clement of Mental Health America noted that while low reimbursement has limited alcohol screenings, other systemic barriers may persist even with higher pay, making the overall impact on behavioral health interventions uncertain.
Why it matters: The 19% reimbursement increase could shift how often doctors provide smoking cessation and substance use counseling, especially since private insurers typically mirror Medicare’s payment models. Though the dollar gain per visit is modest, the policy change may drive broader adoption of structured interventions for millions of patients.
