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Providers

Smoking Cessation

We want to help our members quit smoking. Review our covered products and services below.

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Tobacco Cessation Counseling

To become credentialed as a Tobacco Cessation Counselor (TCC), follow these steps:

  • Enroll in Medical Assistance with a National Provider Identification (NPI) number
  • Click here to 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)
    • 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 TCC.
    • Click here to access 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 (after completing above credentialing):

  • A roster template (update monthly if there are changes) and completed and signed W9 form emailed to  providerdata@jeffersonhealthplans.com
  • To enroll for our Electronic Fund Transfer (EFT) directly, without a fee, click here.

Pharmacy Coverage 

Our formulary covers a wide range of smoking cessation products. Click here to learn more. Please note that we do not cover brand name drugs that have generic equivalents, except with prior authorization.

 


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.