Screening, Brief Intervention,
and Referral to Treatment
(SBIRT) in North Carolina
May 15, 2013
What is SBIRT?
• SBIRT is a comprehensive, integrated, health approach to
the delivery of early intervention and treatment services
for:
– Persons with substance use disorders
– Those who are at risk of developing these disorders
• Primary care, mental health, ER and other community
settings provide opportunities for intervention with at-risk
substance users
Before more severe consequences occur and while it is easier
and less time consuming to intervene
Reimbursement for SBIRT
Payer
Medicaid
Code
Description
Billing Provider
Fee
Schedule
CPT 99408
Alcohol and/or substance abuse structured
MD/DO, NP, Health
screening and brief intervention services; 15 to Departments, PhD, CNP,
30 minutes
LPA, LCSW, LCAS, LPC,
LMFT, CCNS, CCAS, CCS
$30.73
CPT 99409
Alcohol and/or substance abuse structured
screening and brief intervention services;
greater than 30 minutes
$60.41
G0396
Alcohol and/or substance abuse structured
MD, CP, LCSW, NP, CNS, PA
screening and brief intervention services; 15 to
30 minutes
$29.42
G0397
Alcohol and/or substance abuse structured
screening and brief intervention services;
greater than 30 minutes
$57.69
G0442
Alcohol annual misuse screening; 15 minutes MD, CNM, NP, CNS, PA
$17.33
G0443
Brief, face-to-face, behavioral counseling for
alcohol misuse; 15 minutes
$25.14
Medicare
MD/DO, NP, Health
Departments, PhD, CNP,
LPA, LCSW, LCAS, LPC,
LMFT, CCNS, CCAS, CCS
MD, CP, LCSW, NP, CNS, PA
MD, CNM, NP, CNS, PA
Additional Information
Services must be billed incident‐to
the physician (using physician NPI) in the office setting.
1. Pt. must have signs/symptoms of illness.
2. Not reported for routine screening.
1. G0442 reported for routine screening. Once per 12 month period.
2. G0443 reported for brief intervention. Max. 6 times per 12 month
period.
3. Can report both G0042 and G0443 on same date.
Goals of SBIRT
• Help people to identify and modify high-risk
behaviors, often using their own resources
• Increase access to care for persons with
substance use disorders and those at risk of
substance use disorders
• Implement these interventions with minimal
interference with routine office procedures
SBIRT:
Core Clinical Components
• Screening: Very brief screening that identifies
substance related problems
• Brief Intervention: Raises awareness of risks and
motivates patients to acknowledge & address
problem: 1- 2 sessions of 5-8 minutes each
• Referral to Treatment: Referral of those with
more serious addictions to specialized treatment
services.
NC SBIRT Collaborative Agreement
(2011-2016)
• Substance Abuse and Mental Health Services Administration
(SAMHSA)
• NC Division of Mental Health, Developmental Disabilities, and
Substance Abuse Services (Division)
• Northwest Community Care Network (CCNC)
• Community Care of the Sandhills (CCNC)
• Governor’s Institute on Substance Abuse (GI)
• Daymark Recovery Services
• Partnership for a Drug Free NC
• Sandhills Center LME-MCO
• CenterPoint Human Services LME-MCO
NC SBIRT Project
Performance
April 2012-April 2013:
NC SBIRT project has screened over 6,000
patients for substance use across six
participating primary care practices.
NC SBIRT Practices
• Community Care Center (Winston-Salem)
• Wake Forest Family and Community Medicine (WinstonSalem)
• Family Medicine Practice of Dr. Karen Smith (Raeford)
• Wake Forest Family Medicine-Foothills (Mt. Airy)
• Peace Haven Family Medicine (Winston-Salem)
• Pembroke Family Practice Center (Pembroke)
• Southern Pines Women’s Center (Pinehurst)- June 2013
• Robeson County FQHC- August 2013
Training Available for
Non-Grantee Providers
• Trainers:
– Dr. James Finch, MD
Governor’s Institute Director of Physician Education
Medical Director, Changes By Choice
– Dr. Ashwin Patkar, MD, MRCPsych
Associate Professor of Psychiatry, Duke University
Medical Director, Duke Addictions Program
• Sessions for MDs, PEs, nurses, practice administration
• Separate in-depth training available for Behavioral Health
providers
RESOURCES at www.sbirtnc.org
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Screening forms (English/Spanish)
Brief Intervention pocket cards
Slide modules
Instructional videos
Referral resources
Reimbursement information
CME opportunities
www.sbirtnc.org