Maine care tobacco treatment benefit claims data fy 2010
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![Developed by the Maine Public Health Association Tobacco Policy Committee [ako]
Data Provided by Office of MaineCare Services, November 2010
MaineCare Tobacco Treatment Benefit
Claims Data Review—State FY 2010
Pharmacotherapy:
Claim Count
Member
Count
Total
Quantity
Total
Days
Supplied
Total Paid by
MaineCare
Program
28,618 13,533 1,508,598 575,894 $1,267,976.10
Paid Claims for Tobacco Cessation Medicaitons SFY 2010
$17,509.85
$363,368.14
$121,331.01
$15,515.42
$21,255.56
$303,575.20
$968.14
0
50,000
100,000
150,000
200,000
250,000
300,000
350,000
400,000
Buproban Chantix Gum Lozenge Inhaler Patch Spray
Medication Type
TotalAmount
Claims
Cost](https://image.slidesharecdn.com/mainecaretobaccotreatmentbenefitclaimsdatafy2010-101123092655-phpapp02/85/Maine-care-tobacco-treatment-benefit-claims-data-fy-2010-1-320.jpg)
![Developed by the Maine Public Health Association Tobacco Policy Committee [ako]
Data Provided by Office of MaineCare Services, November 2010
Counseling (99401, 99402, 99403, 99406, 99407):
Claim
Count
Member
Count
Total
Billed
Units
Total Paid
Units
Total Paid by
the MaineCare
Program
Total
Adjusted
Amount
2,614 2,066 2,718 2,488 $33,234.14 $35,894.18
Paid Claims fr Tobacco Cessation Counseling
$250.05
$24,703.83
$60.00
$7,730.66
$3,149.64
0
5,000
10,000
15,000
20,000
25,000
30,000
99401 99402 99403 99406 99407
Procedure Code
TotalAmount
Claim Count
Total Cost to
MaineCare
Procedure
Code
Medicaid
Rate
Procedure Description
99401 $5.00 Preventive counseling, individual, 15 min
99402 $22.00 Preventive counseling, individual, 30 min
99403 $10.00 Preventive counseling, individual, 45 min
99406 $8.67 Intensive Counseling (Behavioral Change) 3-10 MIN
99407 $16.81 Intensive Counseling (Behavioral Change) < 10 MIN](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
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Maine care tobacco treatment benefit claims data fy 2010
- 1. Developed by the Maine Public Health Association Tobacco Policy Committee [ako] Data Provided by Office of MaineCare Services, November 2010 MaineCare Tobacco Treatment Benefit Claims Data Review—State FY 2010 Pharmacotherapy: Claim Count Member Count Total Quantity Total Days Supplied Total Paid by MaineCare Program 28,618 13,533 1,508,598 575,894 $1,267,976.10 Paid Claims for Tobacco Cessation Medicaitons SFY 2010 $17,509.85 $363,368.14 $121,331.01 $15,515.42 $21,255.56 $303,575.20 $968.14 0 50,000 100,000 150,000 200,000 250,000 300,000 350,000 400,000 Buproban Chantix Gum Lozenge Inhaler Patch Spray Medication Type TotalAmount Claims Cost
- 2. Developed by the Maine Public Health Association Tobacco Policy Committee [ako] Data Provided by Office of MaineCare Services, November 2010 Counseling (99401, 99402, 99403, 99406, 99407): Claim Count Member Count Total Billed Units Total Paid Units Total Paid by the MaineCare Program Total Adjusted Amount 2,614 2,066 2,718 2,488 $33,234.14 $35,894.18 Paid Claims fr Tobacco Cessation Counseling $250.05 $24,703.83 $60.00 $7,730.66 $3,149.64 0 5,000 10,000 15,000 20,000 25,000 30,000 99401 99402 99403 99406 99407 Procedure Code TotalAmount Claim Count Total Cost to MaineCare Procedure Code Medicaid Rate Procedure Description 99401 $5.00 Preventive counseling, individual, 15 min 99402 $22.00 Preventive counseling, individual, 30 min 99403 $10.00 Preventive counseling, individual, 45 min 99406 $8.67 Intensive Counseling (Behavioral Change) 3-10 MIN 99407 $16.81 Intensive Counseling (Behavioral Change) < 10 MIN
- 3. Developed by the Maine Public Health Association Tobacco Policy Committee [ako] Data Provided by Office of MaineCare Services, November 2010 Copay Costs to Medicaid Recipients By Pharmacotherapy SFY 2010 $1,056.30 $40,562.26 $11,038.61 $705.63 $36,528.11 $1,816.81 $248.20 $- $5,000.00 $10,000.00 $15,000.00 $20,000.00 $25,000.00 $30,000.00 $35,000.00 $40,000.00 $45,000.00 Buproban Chantix Gum Lozenge Patch Inhaler Spray Medication TotalCopayPaid Elimination of copay requirements, based on SFY 2010 data, would cost the State of Maine less than $100,000 annually ($91,956 in SFY 2010).