Information For Dates of Service On and After October 1, 2015

Tobacco Cessation Drugs and Services

Under the outpatient mental health benefit, BadgerCare Plus and Wisconsin Medicaid cover medically necessary diagnostic evaluations and psychotherapy related to tobacco cessation provided by psychiatrists, Ph.D. psychologists, and Master's-level therapists.

BadgerCare Plus and Wisconsin Medicaid cover psychotherapy on an individual and group basis.

Drugs for Tobacco Cessation

The BadgerCare Plus Standard Plan, Medicaid, and SeniorCare cover generic legend drugs for tobacco cessation.

Nicotine gum or patches available OTC are covered by the Standard Plan and Medicaid.

Certain Standard Plan members may be eligible to participate in Striving to Quit Wisconsin Tobacco Quit Line or First Breath initiatives.

A written prescription from a prescriber is required for generic legend and OTC tobacco cessation products. Prescribers are required to indicate the appropriate diagnosis on the prescription. PA is required for uses outside the allowable ICD diagnoses included in the table below.