Press Release

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(Washington, D.C.)—Today, the White House Office of National Drug Control Policy (ONDCP) announced that approximately 5.6 million Federal workers with Federal health insurance will now be covered for a substance abuse prevention and treatment procedure called Screening and Brief Intervention (SBI). The new coverage will reimburse doctors who screen their patients for a full spectrum of substance use behaviors, including for alcohol, illicit drugs, and prescription drug abuse/addiction, and provide appropriate intervention.

The U.S. Office of Personnel Management (OPM) asked carriers participating in the Federal Employees Health Benefits (FEHB) program to review new Current Procedural Terminology (CPT®) codes for screening and short-term intervention for alcohol and substance abuse. The new codes, CPT® 99408 and CPT® 99409, are American Medical Association (AMA) codes used by physicians to report and bill health insurance plans for their services. OPM stated at least 70% of enrollees participate in FEHB plans which will recognize the codes for their claims processing systems when services are delivered by a medical professional.

SBI is a medical procedure that aims to break the cycle of drug and alcohol abuse and addiction, and the negative consequences resulting from these behaviors. SBI procedures are performed in primary medical settings, like doctors' offices, emergency and trauma centers, pediatric and prenatal care clinics, and school-based healthcare settings. SBI facilitates a constructive dialogue between doctors and patients about the harms of substance abuse, risks for the disease of addiction, and strategies to help patients achieve sobriety. Through SBI, patients can be referred to an appropriate level of care or specialty treatment. According to the 2007 National Survey on Drug Use and Health, over 20 million Americans meet the clinical definition of substance abuse or addiction. It is estimated that 95.5 percent of these individuals are unaware of their problem or have not sought treatment or interventions from healthcare professionals.

"By opening the lines of communication between doctors and patients, SBI can help identify users and reduce substance use and its associated consequences," said Dr. Bertha Madras, Deputy Director for Demand Reduction at the White House Office of National Drug Control Policy. "This intervention assists an individual engaged in risky substance abuse to change their behaviors - behaviors associated with adverse medical events such as accidents, injuries, trauma, overdoses, medical conditions (depression, hypertension, sleep disorders, infections), social consequences, and the slide toward drug and alcohol addiction. SBI is a public health procedure that can readily be implemented across the entire healthcare sector and in all 50 States. It assists individuals using drugs and alcohol by providing timely and cost-effective interventions. I applaud the Federal insurers for recognizing the merits and benefits of SBI for their members, and their patients."

The Centers for Medicare and Medicaid Services (CMS) adopted SBI codes in January 2007, while the AMA's addition of two CPT® codes became effective in January 2008. CMS has also line-itemed SBI in their annual budget, with a $265 million set-aside to match State contributions for Medicaid for those States implementing the codes and reimbursing for SBI services.

For more information about SBI, please visit: http://www.ondcp.gov/treat/screen_brief_intv.html.