Substance Use Screenings – CMS Coding & Billing Update

May 31, 2024

Substance Use Screenings – CMS Coding & Billing Update

Screening, Brief Intervention & Referral to Treatment (SBIRT) is an evidence-based, early detection and intervention approach for people with non-dependent substance use before they need more extensive or specialized treatment. This approach is different for people who are already diagnosed with an SUD (substance use disorder).

The Centers for Medicare & Medicaid Services (CMS) pay 100% of the Medicare Physician Fee Schedule (PFS) for medically reasonable and necessary SBIRT services in both physicians’ offices and outpatient hospital settings, including public health centers, emergency departments, and primary and specialty care physicians’ offices. Download the revised Factsheet for more information on payment and coverage requirements.

What Been Added:

  • Examples of locations where Medicare-eligible providers can perform these services
  • Marriage and family therapists and mental health counselors to list of eligible providers

And Additional Information Added About:

  • Telehealth flexibilities
  • Evaluation and management for medication management

Eligible Providers:

CMS updated the eligible providers table with coverage requirements and payment information