Designed specifically for use by Treatment Professionals who bill insurance The National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention has developed Screening and Brief Intervention (SBI) for Unhealthy Alcohol Use: A Step-by Step Implementation Guide for Trauma Centers.
S.B.I.R.T. — Reimbursement for Screening, Brief Intervention, and Referral to Treatment
What is SBIRT? SBIRT is a comprehensive, integrated, public health approach to the delivery of early intervention and treatment services for persons with substance use disorders, as well as those who are at risk of developing these disorders. Primary care centers, hospital emergency rooms, trauma centers and other community settings provide opportunities for early intervention with at-risk substance users before more severe consequences occur.
- Screening quickly assesses the severity of substance use and identifies the appropriate level of treatment.
- Brief Intervention focuses on increasing insight and awareness regarding substance use and motivation toward behavioral change.
- Referral to Treatment provides those identified as needing more extensive treatment with access to specialty care.
Treatment Solutions & SBIRT:
With Treatment Solutions you find the “T” in the SBIRT process – a network of 20 Treatment facilities across the U.S. and internationally.
When you need to make a Referral, Treatment Solutions finds the most appropriate treatment setting for your patients with alcohol and drug problems by:
- Matching your patients to treatment based on their clinical needs and insurance/financial resources
- Putting the referral and admission process into motion, which includes benefits verification, assessment & placement, travel & admission, clinical oversight, discharge planning follow up post-discharge
One call to 877-417-6237 starts the process.
| 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 service, brief intervention, per 15 minutes | $48.00 |
Important Medicare Information: In the case of Medicare, SBIRT services are defined as alcohol and/or substance (other than tobacco) abuse structured assessment (e.g., AUDIT, DAST) 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: http://www.cms.gov/MLNgeninfo/
DISCLAIMER: It is your responsibility to understand and follow your state and local laws governing the practice of medicine and medical coding and billing. The appearance of modifiers or codes on this website does not necessarily indicate coverage.
