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