№ lp_2_3_60033
Policy and clinical guidance document outlining Medicare reimbursement provisions, eligibility criteria, screening procedures using PHQ-9 and PHQ-2, severity-based treatment considerations, and suicide risk assessment protocols for depression screening in adults within primary care settings.
Medicare Benefit: Reimbursed screening for depression in adults once-a-year under Fee-for-Service Medicare available since October 14, 2011; no coinsurance; no deductible for patient
Procedure Code: G0444 (Depression Screen – 15 minutes)
Eligibility: Primary care settings with depression care supports in place
Points of Care Eligible for Reimbursement: Primary care office; outpatient hospital; independent clinic; federally qualified health center (FQHC); state and local health clinic; rural health clinic (RHC)
Referral Options: Local community mental health center; American Psychiatric Association; American Psychological Association; National Association of Social Work
Recommended Screening Tool: Patient Health Questionnaire (PHQ-9); PHQ-2
Severity Classification: PHQ-9 score ranges from 0 to 20 or greater with corresponding provisional diagnoses and treatment considerations
Assessment of Suicidal Risk: Follow-up questions based on response to PHQ-9 item 9; adapted from the P4 screener
Adapted From: Kroenke K, Spitzer RL, Psychiatric Annals 2002; Dube P et al., Prim Care Companion J Clin Psychiatry 2010
Developed By: Patient Centered Primary Care Coalition Behavioral Health Workgroup
Approval Status: Board Approval Pending
Subject: Medicare reimbursement policy and clinical guidance for adult depression screening in primary care
Document Type: Policy and clinical guidance document
Price: 8 / 10 USD
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