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Coding for SBI Reimbursement

Reimbursement for screening and brief intervention is available through commercial insurance CPT codes, Medicare G codes, and Medicaid HCPCS codes. Information regarding these codes can be found in the table below.

Important Medicare Information

SAMHSA is working with the Centers for Medicare and Medicaid Services (CMS) to educate practitioners about the importance of SBIRT coverage and the Medicare billing rules around these services.  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. 

Available for Download

More information can be found at the Medicare Learning Network: http://www.cms.gov/MLNgeninfo/.

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

 

Last updated: 04/16/2012

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