Summary & Overview

HCPCS G9902: Patient Screened for Tobacco Use, Identified as User

HCPCS Level II code G9902 documents that a patient was screened for tobacco use and identified as a tobacco user. This code captures a discrete preventive screening event that informs counseling, cessation interventions, and care planning. Nationally, consistent capture of tobacco-use screening supports public health monitoring and payer quality programs tied to preventive care metrics.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what the code represents, where the service is typically delivered, and how payers commonly handle coverage for tobacco-use screening services. The publication summarizes benchmarking context, common modifier usage as reported in payer guidance, and clinical context for integrating screening results into care workflows.

The report provides practical reference material for billing and coding teams, clinical operations, and compliance staff seeking clarity on documentation expectations and claims submission practices for tobacco-use screening when a patient is identified as a tobacco user. Data not available in the input is noted where payer-specific rates, taxonomies, or related diagnosis coding are not provided.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareG9902HCPCS Level IItobacco screeningpreventive servicesoutpatientambulatory carequality measuresscreening and brief intervention

Billing Code Overview

HCPCS Level II code G9902 indicates a patient screened for tobacco use and identified as a tobacco user. The service represented is tobacco use screening, typically performed as a brief assessment during an outpatient or ambulatory visit where preventive screening and counseling occur. Typical sites of service include primary care clinics, outpatient offices, community health centers, and other ambulatory care settings where screening for tobacco use is part of routine patient evaluation.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is a 45-year-old adult presenting to a primary care clinic for an annual wellness visit. During rooming, a medical assistant performs routine screening and documents current tobacco use. The patient reports daily cigarette smoking and readiness to quit is assessed. The clinician confirms tobacco use, provides brief counseling, and offers cessation resources or referral to a tobacco cessation program. The screening is documented in the electronic health record with tobacco use status, counseling provided, and any referrals or prescriptions. The service is commonly billed when a patient is identified as a tobacco user during encounters in an outpatient clinic, community health center, or preventive care setting.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when additional work or complexity is documented beyond usual tobacco screening (rare for G9902).
`23`	Unusual anesthesia	Not typically applicable; retained only if anesthesia unexpectedly used (unlikely).
`52`	Reduced services	Use when the screening was partially performed or discontinued and documented.
`53`	Discontinued procedure	Use when screening was started but stopped due to patient condition or refusal.
`55`	Postoperative management only	Not applicable to routine tobacco screening; rarely used.
`56`	Preoperative management only	Not applicable to routine tobacco screening.
`62`	Two surgeons	Not applicable to this non-procedural service.
`AS`	Physician assistant or non-physician practitioner billing as assistant at surgery	Not applicable; included for completeness.
`CQ`	Service furnished by a physical therapist in a rural health clinic or federally qualified health center	Use when a qualifying therapist documents and performs the screening in an FQHC/RHC setting if policy supports billing.
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures	Not applicable to tobacco screening.

Taxonomy Code	Specialty	Notes
`208000000X`	Family Medicine	Primary site for preventive screening and counseling.
`208D00000X`	Internal Medicine	Commonly documents tobacco use during adult primary care visits.
`207Q00000X`	Obstetrics & Gynecology	Screens patients during prenatal and routine women's health visits.
`163W00000X`	Preventive Medicine	Provides structured screening programs and population health interventions.
`367A00000X`	Health Education/Promotion	May perform screening and counseling in community programs.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z72.0`	Tobacco use	Directly identifies current tobacco use documented during screening.
`F17.200`	Nicotine dependence, unspecified, uncomplicated	Indicates nicotine dependence when screening identifies dependence and supports cessation interventions.
`Z87.891`	Personal history of nicotine dependence	Used when patient has past dependence; relevant for documentation of tobacco history.
`R07.9`	Chest pain, unspecified	Example symptom that may prompt screening and linkage to tobacco cessation counseling.
`J44.9`	Chronic obstructive pulmonary disease, unspecified	Common tobacco-related diagnosis that often coexists with documented tobacco use.
`I25.10`	Atherosclerotic heart disease of native coronary artery without angina pectoris	Tobacco use is a risk factor and documentation supports risk-factor modification counseling.
`Z71.6`	Tobacco abuse counseling	Used when counseling is provided; complements screening code `G9902`.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99406`	Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes	Used for brief counseling sessions following identification of tobacco use.
`99407`	Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes	Used when extended counseling is provided after screening identifies a tobacco user.
`G0436`	Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes up to 10 minutes	Medicare-specific HCPCS for counseling that may follow a positive tobacco screen.
`G0437`	Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes	Medicare-specific HCPCS for intensive counseling following identification of tobacco use.
`99401`	Preventive medicine counseling, individual; approximately 15 minutes	May be used when counseling is provided as part of a preventive visit addressing tobacco use.