Coding for Screening and Brief Intervention Reimbursement
Reimbursement for screening and brief intervention is available through commercial insurance, Medicare, and Medicaid.
Important Medicare Information
SAMHSA is working with the Centers for Medicare and Medicaid Services to educate practitioners about the importance of SBIRT coverage and the Medicare billing rules around these services. SBIRT services are defined as alcohol and/or substance (other than tobacco) abuse structured assessment (for example, Alcohol Use Disorders Identification Test, Drug Abuse Screening Test) and brief intervention. Medicare may not pay for screening services unless specifically required by statute.
More information can be found at the Medicare Learning Network.
Reimbursement for SBIRT
|
Payer |
Code |
Description |
Fee Schedule |
|
Commercial Insurance |
CPT 99408 |
Alcohol and/or substance abuse structured screening and brief intervention services; 15 to 30 minutes |
$33.41 |
|
CPT 99409 |
Alcohol and/or substance abuse structured screening and brief intervention services; greater than 30 minutes |
$65.51 |
|
|
Medicare |
G0396 |
Alcohol and/or substance abuse structured screening and brief intervention services; 15 to 30 minutes |
$29.42 |
|
G0397 |
Alcohol and/or substance abuse structured screening and brief intervention services; greater than 30 minutes |
$57.69 |
|
|
Medicaid |
H0049 |
Alcohol and/or drug screening |
$24.00 |
|
H0050 |
Alcohol and/or drug screening, brief intervention, per 15 minutes |
$48.00 |