Screening, Brief Intervention and Referral to Treatment (SBIRT) Reminders

Screening, Brief Intervention and Referral to Treatment (SBIRT) Reminders

1/18/2017

BlueCross® BlueShield® of South Carolina and BlueChoice HealthPlanadopted the Screening, Brief Intervention and Referral to Treatment (SBIRT) program in 2014. The program allows network participating obstetricians/gynecologists and midwives to identify at-risk patients by using the SBIRT Integrated Screening Tool (the SBIRT referral).
 

Who participates?

 
This initiative is available to all BlueCross and BlueChoice® plans except:
  • Federal Employees Program (FEP)
  • Out-of-state members (BlueCard®)
  • State Children’s Health Insurance Program (SCHIP)
  • Plans that do not have maternity benefits

What codes do you file?

We will reimburse obstetricians/gynecologists and midwives for performing the screening and intervention:

H0002: Behavioral health screening

  • Completion of the SBIRT referral for the screening
  • Screening, can be billed once per 12-month period
  • Append the HD modifier for positive screenings only
  • Reimbursement is $24.00
H0004: Behavioral health intervention
  • Intervention and referral to treatment, documented within the SBIRT referral
  • Brief intervention, can be billed twice per 12-month period
  • Defined as a brief intervention or session in which a referral is made or attempted
  • Reimbursement is $48.00

Points to Remember

  1. There is no cost to applicable members for these services
  2. Charges must be submitted with a primary diagnosis code that is maternity or post-partum related
  3. The secondary diagnosis must be Z13.9
  4. If claims are not submitted with the appropriate diagnosis codes, members may incur cost sharing (deductible, copayment or coinsurance)

If you have questions about this bulletin, please contact Provider Education by using the Provider Education Contact Form or by calling 803-264-4730.

BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association.