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
- Substance (Other Than Tobacco) Abuse Structured Assessment and Brief Intervention (SBIRT) Service (PDF | 515 kbytes)
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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