Summary & Overview
CPT 1036F: Tobacco Use Screening, Adult Nonuser
CPT code 1036F denotes that a provider screened an adult patient (18 years or older) for tobacco use and determined the patient to be a nonuser. As a standardized screening outcome code, it supports preventive care documentation, quality measurement, and population health monitoring. Nationally, consistent use of this code helps track tobacco-use screening rates and informs public health efforts to reduce tobacco-related morbidity.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. These payers commonly require clear documentation of screening and outcomes to support quality reporting and potential performance-based programs.
Readers will find an overview of the clinical context for tobacco-use screening in adults, the typical service setting (ambulatory and primary care), and the administrative role of the code in quality measurement. The publication also outlines common modifiers and other administrative elements associated with billing (where provided) and highlights where data was not available in the input. The content is intended for a national audience including clinicians, coders, and policy analysts interested in documentation standards and preventive care coding practices.
Billing Code Overview
CPT code 1036F documents that the provider screened a patient aged 18 years or older for tobacco use and identified the patient as a nonuser of tobacco. This code represents a screening outcome rather than a diagnostic or treatment procedure.
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Service type: Preventive screening for tobacco use status
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Typical site of service: Ambulatory outpatient settings such as primary care clinics, preventive care visits, and community health centers where routine screening and health behavior assessments are performed.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 42-year-old patient presents to a primary care clinic for an annual preventive visit. As part of routine screening, the provider asks standardized questions about current and past tobacco use, documents that the patient denies current use of cigarettes, e-cigarettes, cigars, smokeless tobacco, or other nicotine products, and records the tobacco-use status as a nonuser. The screening occurs during an in-person visit at an outpatient clinic or during a synchronous telehealth encounter when permitted. The workflow includes intake screening by nursing staff or an electronic questionnaire, verification by the provider, documentation of the patient as a tobacco nonuser in the medical record, and selection of the screening code for billing purposes when the patient is 18 years or older.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
95 | Synchronous telemedicine service rendered via real-time interactive audio and video | Use when the tobacco-use screening is performed live via telehealth that meets payer telemedicine criteria |
GT | Via interactive audio and video telecommunication systems | Use when the screening is provided through a telehealth platform accepted by the payer that recognizes GT
| Service furnished via an asynchronous telecommunication system | Use when a certified asynchronous communication method is used and the payer accepts for such screening