Administrator’s Message: Behavioral Health
Screening and Primary Care
L. Cline, Ph.D.
One of SAMHSA’s most effective programs—the
Screening, Brief Intervention, and Referral
to Treatment (SBIRT) Initiative—is reporting excellent
outcomes in the field. (See Screening
Works: Update from the Field.)
Preliminary SBIRT data show a total
of 74 percent of high-risk individuals
reported lowering their drug or alcohol
consumption after one or more brief
treatment sessions, and 48 percent
reported stopping use.
Making behavioral health screening
part of primary care makes sense. By
taking a public health approach to
substance abuse and mental health issues,
we can lower health care costs because
we’re reaching individuals before
they need specialized treatment.
Another step forward in support of
screening comes from the American Medical
Association (AMA). In January 2008,
the AMA introduced new health care
codes for substance abuse screening
and brief intervention.
These new codes offer a mechanism
for health care providers to be reimbursed
for using these tools. The codes will
increase the likelihood that those
with substance abuse problems receive
an appropriate intervention before
developing a disorder, and those with
a disorder will be linked to appropriate
treatment and recovery support services.
The Centers for Medicare & Medicaid
Services (CMS) recently approved “HCPCS
codes” to reimburse for screening
and brief interventions under Medicaid.
Those codes now can be used on a state-by-state
basis for early screening and intervention
for substance use disorders.
For use under Medicare, CMS created “G
codes” to reimburse providers
for these services.
These changes signal a meaningful
shift in how substance abuse is being
viewed by those in general health care,
in health policy, and in health care
The SBIRT model holds great promise.
To help the Initiative reach its full
potential, SAMHSA will be coordinating
with many Federal agencies, including
the Office of National Drug Control
Policy, the Centers for Disease Control
and Prevention, the National Institute
on Drug Abuse, and the National Institute
on Alcohol Abuse and Alcoholism.
Terry L. Cline, Ph.D.