The US Preventive Services Task Force (USPSTF) recommends screening for alcohol misuse and behavioral interventions for individuals whose screening results are positive.
Medicare pays for an annual screening for alcohol misuse for all Medicare beneficiaries using HCPCS code G0442.
For those who screen positive, Medicare also pays for a brief face-to-face behavioral counseling session, HCPCS code G0443.
Both of these are 15 minute codes. In order to bill them, the record must show that the service took over half of the threshold time, or 7.5 minutes.
G0442 annual alcohol misuse screening, 15 minutes
G0443 Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes
|Code||Description||2020 wRVU||National non-facility payment||National facility payment|
|G0442||Annual alcohol misuse screening, 15 minutes||0.18||$18.41||$9.74|
|G0443||Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes||0.45||$26.71||$24.18|
State Medicaid programs can individually decide whether or not to restrict coverage based on specialty designation of the provider. Check with commercial payers.
All Medicare patients are eligible for screening, and patients who have a positive screen for alcohol misuse are eligible for counseling. Screening is covered annually, and counseling for those who screen positive, is covered four times/year.
Login to read the rest of this article
Don’t have a login? Become a member, or learn more about the benefits of membership by clicking on the link below.