assessment standardized screening tool is be billed only when a Strengths and Difficulties recommended. standardized screening tool 96127 may be combined with other screening Questionnaire (SDQ) is used and results codes (ex. 96110) for a maximum of 2 units of Ages and Stages documented screening per visit Questionnaire Social – Emotional (ASQ-SE) Early Childhood Screening Assessment Depression Screening recommended 96127: Brief emotional/ A maximum of 2 units of 96127 will be PHQ-9 Modified for Teens screening annually beginning at 11 behavioral assessment may reimbursed per visit; OR Pediatric Symptom years of age. If providers be billed only when a Checklist (PSC-Y) choose, they can 96127 may be combined with other screening standardized screening tool “pre-screen” Center for Epidemiological with PHQ-2 to determine if a is used and results codes (ex. W7000) for a maximum of 2 units of Studies Depression Scale longer standardized screening documented. PHQ-2 may screening per visit for Children (CES-DC) tool is needed. not be billed. Beck Depression Inventory (BDI) Substance use Annually beginning at 11 W7000: Alcohol and/or A maximum of 1 unit of W7000 will be CRAFFT assessment years of age; use of brief substance use disorder reimbursed annually for recipients age 11 and up CAGE-AID screening tool is screening may be billed only recommended. when a standardized W7000 may be combined with other screening screening tool is used and codes (ex. 96127) for a maximum of 2 units of Positive screens should be results documented. screening per visit followed by brief intervention and referral for W7020: Intervention; > 3 A maximum 4 interventions will be reimbursed treatment when indicated minutes up to 10 minutes annually per recipient age 11 and up (SBIRT: Screening, Brief Intervention, and Referral to W7021: Intervention; >10 Treatment) minutes up to 20 minutes W7022: Intervention; >20 minutes
assessment standardized screening tool is recommended. Strengths and Difficulties Questionnaire (SDQ) Ages and Stages Questionnaire – Social Emotional (ASQ-SE) Early Childhood Screening Assessment be billed only when a standardized screening tool is used and results documented 96127 may be combined with other screening codes (ex. 96110) for a maximum of 2 units of screening per visit Depression screening Screening recommended annually beginning at 11 years of age. If providers choose, they can “pre-screen” with PHQ-2 to determine if a longer standardized screening tool is needed. PHQ-9 Modified for Teens Pediatric Symptom Checklist (PSC-Y) Center for Epidemiological Studies Depression Scale for Children (CES-DC) Beck Depression Inventory (BDI) 96127: Brief emotional/ behavioral assessment may be billed only when a standardized screening tool is used and results documented. PHQ-2 may not be billed. A maximum of 2 units of 96127 will be reimbursed per visit; OR 96127 may be combined with other screening codes (ex. W7000) for a maximum of 2 units of screening per visit Substance use assessment Annually beginning at 11 years of age; use of brief screening tool is recommended. Positive screens should be followed by brief intervention and referral for treatment when indicated (SBIRT: Screening, Brief Intervention, and Referral to Treatment) CRAFFT CAGE-AID W7000: Alcohol and/or substance use disorder screening may be billed only when a standardized screening tool is used and results documented. W7020: Intervention; > 3 minutes up to 10 minutes W7021: Intervention; >10 minutes up to 20 minutes W7022: Intervention; >20 minutes A maximum of 1 unit of W7000 will be reimbursed annually for recipients age 11 and up W7000 may be combined with other screening codes (ex. 96127) for a maximum of 2 units of screening per visit A maximum 4 interventions will be reimbursed annually per recipient age 11 and up
H.-Billing-for-Services-to-Children-Not-in-a-MCO-(Fee-For-Service)-2017.docx