Smoking Cessation
Do you want to help your Health Partners Plans patients quit smoking? We can help with our covered products and services listed below.
Tobacco Cessation Counseling
To become credentialed as a TCC:
- Enroll in Medical Assistance with a National Provider Identification (NPI) number
- Complete the “Every Smoker, Every Time” online training and submit the “Pre-Approved Tobacco Cessation Registry Application”, along with the “Every Smoker, Every Time” notification email to the Pennsylvania Department of Health (DOH)
- Training, application and contact information are located at: https://www.health.pa.gov/topics/programs/tobacco/pages/registry.aspx
- Tobacco cessation counseling certification as an Individual TCC provider type is required
- Check the box to be referred to DHS Medical Assistance (MA) to have your “Pre-Approved Tobacco Cessation Registry Application” and notification email forwarded to DHS MA. You must check yes to the following: “If your program is approved, would you like to be referred to the Department of Human Services (DHS) for review and approval by Medical Assistance for reimbursement of tobacco cessation services?”
- A Medicaid PROMISe number is required for billing purposes
- DOH will send a fax to confirm your application has been approved and a link to the DHS MA application for the PROMISe number.
- Pharmacists must then apply for an individual PROMISe number as a Tobacco Cessation Counselor.
- The following link provides the DHS MA PROMISe number application:
- https://www.dhs.pa.gov/providers/Providers/Pages/PROMISe-Enrollment.aspx
- The MA Program enrolls DOH-approved pharmacists as Tobacco Cessation Providers (PT 37) with a provider specialty of 370.
To bill for reimbursement as a TCC with HPP (after completing above credentialing):
- A roster template (update monthly if there are changes): email to providerdata@hpplans.com Completed and signed W9 form : email to providerdata@hpplans.com
- To enroll for HPP Electronic Fund Transfer (EFT) directly, without a fee, use this link: https://view.echohealthinc.com/EFTERADirect/HealthPartnersPlans/
Pharmacy Coverage
Our formulary covers a wide range of smoking cessation products. Please note that we do not cover brand name drugs that have generic equivalents, except with prior authorization.
| Product | Covered | Prior Authorization Needed? |
| Gum | Yes | No |
| Inhaler | Yes | No |
| Lozenges | Yes | No |
| Nasal Spray | Yes | No |
| Patch | Yes | No |
| Budeprion (generic for Wellbutrin) | Yes | No |
| Buproban (generic for Wellbutrin and Zyban combination | Yes | No |
| Chantix (generic for Varenicline) | Yes | No |
| Wellbutrin (brand only) | Non-Formulary | Yes (letter of medical necessity required) |
| Zyban (brand only) | Non-Formulary | Yes (letter of medical necessity required) |
Counseling Services
We can assist in connecting any member to tobacco counseling services. To refer a patient for assistance, please contact Clinical Programs at 866-500-4571.
Additional Resources
Here are free support services and tools available to anyone trying to quit smoking:
- PA Free Quitline: 1-800-QUIT-NOW
- American Lung Association Help Line: 1-800-LUNG-USA and their Freedom from Smoking online quit tool
- Philadelphia Department of Public Health: www.smokefreephilly.org