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:
- 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 email@example.com Completed and signed W9 form : email to firstname.lastname@example.org
- To enroll for HPP Electronic Fund Transfer (EFT) directly, without a fee, use this link: https://view.echohealthinc.com/EFTERADirect/HealthPartnersPlans/
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?|
|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)|
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.
Here are free support services and tools available to anyone trying to quit smoking: