Medicare Covers Screening for Depression

Medicare recently added annual depression screening as a covered preventive service, in accordance with the Affordable Care Act. Effective Oct. 14, 2011, adult Medicare patients may receive depression screening once every 12 months in the primary care setting without a copay or deductible.

Requirement: The provider must have in place staff-assisted depression care supports who can advise the physician of screening results and who can facilitate and coordinate referrals to mental health treatment.

Report: The type of service is 1 and the HCPCS Level II code is G0444 Annual depression screening, 15 minutes.

Another thing to consider is whether your organization qualifies as a “primary care setting.” According to MLN Matters article MM7637, effective for claims with dates of service on or after the implementation date (April 2, 2012), contractors will pay for annual depression screening only when provided at the following places of service:

11 – Office
22 – Outpatient hospital
49 – Independent clinic
50 – Federally qualified health center
71 – State or local public health clinic
72 – Rural health clinic

Limitations: Places of service that are not considered a primary care setting include: emergency departments (EDs), inpatient hospitals, ambulatory surgical centers (ASCs), independent diagnostic testing facilities, skilled nursing facilities (SNFs), inpatient rehabilitative facilities, and hospice. Also, treatment options—such as self-help materials, phone calls, etc.—are not included under this Medicare Part B benefit.

For further depression screening coding and billing guidance, read the complete MLN Matters article on the Centers for Medicare & Medicaid Services (CMS) website.


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5 Responses to “Medicare Covers Screening for Depression”

  1. Bonnie Scott says:

    This is a wonderful thing, there are so many people that are suffering from depression, and there is no help for them. With the limit to some insurances this is not covered. So with this it is going to help so many people who suffer from this diease.

  2. Jesus Brightwin says:

    Its a boon to the Depressed people and it may make them out of depression and lead a stressless life. Its a Good NEWS!

  3. Anne Sesing says:

    Gee ….maybe Obamacare is not such a horrible thing!

  4. CConti says:

    WOW. Great! Hope a lot of people take advantage of this. Did ever say anything on the news?

  5. Tarra says:

    I am having a hard time getting this paid for. I am billing G0439, 99497-33 and G0444. Medicare denies the G0444 saying it’s bundled service. What modifier is supposed to be used and is it on the G0439 or the G0444??

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