Substance Use and Mental Health Screening

This page is for Community Services Boards and all other Medicaid providers (complete list below) who will make use of Substance Use and Mental Health screening instruments.

Introduction

Welcome to the Department of Behavioral Health and Developmental Services (DBHDS) resource page on Screening and Brief Intervention (SBI) for alcohol and other substance use problems. This site offers a wide variety of substance abuse screening tools, guidance, and other information for providers who wish to learn more about screening individuals for substance use and mental health problems.

Screening, Brief Intervention and Referral to Treatment (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. The purpose of SBI is to identify individuals who may have alcohol and/or other substance use problems. Following screening, a brief intervention is provided to educate individuals about their use, alert them to possible consequences and, if needed, begin to motivate them to take steps to change their behavior. Reimbursement for screening and brief intervention is now available through commercial insurance CPT codes, Medicare G codes, and Medicaid HCPCS codes.

Virginia was one of 10 states in 2008 that activated these new substance abuse prevention and treatment health codes for screening and brief intervention (SBI) of Medicaid-eligible patients. In May 2008, the Virginia Department of Medical Assistance Services (VaDMAS) released a Special Memo to Providers announcing two new screening codes for use by providers for both Fee-for-Service and Managed Care Medicaid clients (including MEDALLION and FAMIS Plus enrollees). These codes are used to reimburse providers who complete a structured substance abuse screening and provide a brief intervention.

In Virginia, if they have a provider agreement with Medicaid, the following providers may bill Medicaid for SBI services: doctors, nurse practitioners, psychiatric clinical nurse specialists, licensed professional counselors, licensed clinical psychologists, licensed clinical social workers, licensed marriage and family therapists, licensed substance abuse treatment practitioners, all MCOs, and behavioral health (mental health and substance abuse) and developmental services agencies. Prior authorization is not required for SBI services.

Although Virginia’s Medicaid Managed Care Organizations (MCOs) reimburse for screening and brief intervention services, they do not recognize all providers. Providers should check with their local managed care organizations to be sure they are recognized as eligible providers of SBI services.

The VaDMAS 2008 memo listed only two approved screening tools; however, with input from DBHDS, VaDMAS has since approved a variety of other substance abuse screening instruments. Each of the substance abuse screening tools listed on this site has been approved for Medicaid reimbursement by VaDMAS. In order to receive Medicaid reimbursement for substance abuse SBI services, providers must use a VaDMAS approved substance abuse screening tool and also provide a brief intervention. Although Medicaid does not reimburse for mental health screening, DBHDS has identified several mental health screening instruments you may also find helpful.

This site provides educational information and links to validated screening tools for several populations: adults (18–64), older adults (65 and up), adolescents, and pregnant women and women of child bearing age. In the population-specific sections you will find a short summary about each screening instrument, information on its use, a link to the tool and, if the tool is not in the public domain, fees for its use. We have also provided contact information for DBHDS staff members who can respond to questions or suggestions you may have about screening tools and the information on this site.

We will be improving upon and adding more information to this site over time. Thank you for your interest.

Medicaid Reimbursement for Substance Use Screening and Brief Intervention Services

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