The Centers for Medicare and Medicaid Services (CMS) released a fact sheet on Medicaid and Medicare coverage of Screening, Brief Intervention, and Referral to Treatment (SBIRT) services. SBIRT is an evidence-based model to identify problem drinking and substance use and prevent substance use disorders. The CMS resource is intended to inform providers about Medicaid coverage of SBIRT services, the types of providers that may deliver these services, and billing for them. In particular, the fact sheet explains in Medicaid:
- A licensed provider may recommend the screening and practitioners who meet the provider qualifications established by the state in their State Plan may provide the brief intervention.
- SBIRT is covered under EPSDT for children, but may be provided at the state's option for adults.
- There are various billing codes state Medicaid programs may choose to use for this set of services, which are outlined in the document.
In addition, the document discusses SBIRT services for dual eligible beneficiaries. It notes that providers should bill SBIRT services to bill Medicare and the claim will be transferred to Medicaid, as appropriate. The CMS fact sheet is available here.