Medicare Covers Depression Screening - Eff 10/14/11
Effective for claims with Dates of Service on and after October 14,
2011, Medicare will cover annual depression screening for adults in the
primary care setting.
MLN Matters® Number: MM7637
Related Change Request (CR) #: 7637
Related CR Release Date: November 23, 2011
Effective Date: October 14, 2011
Related CR Transmittal #: R139NCD and R2359CP
Implementation Date: April 2, 2012
Effective October 14, 2011, Medicare covers annual screening for adults
for depression in the primary care setting that has staff-assisted
depression care supports in place to assure accurate diagnosis,
effective treatment, and follow-up.
Medicare contractors will recognize new Healthcare Common Procedure
Coding System (HCPCS) code, G0444, annual depression screening, 15
minutes, as a covered service.
At a minimum level, staff-assisted depression care supports consist of
clinical staff (e.g., nurse, Physician Assistant) in the primary care
office who can advise the physician of screening results and who can
facilitate and coordinate referrals to mental health treatment. More
comprehensive care supports include a case manager working with the
primary care physician; planned collaborative care between the primary
care provider and mental health clinicians; patient education and
support for patient self-management; plus attention to patient
preferences regarding counseling, medications, and referral to mental
health professionals with or without continuing involvement by the
patient's primary care physician.
Note: Coverage is limited to screening services and does not include
treatment options for depression or any diseases, complications, or
chronic conditions resulting from depression, nor does it address
therapeutic interventions such as pharmacotherapy, combination therapy
(counseling and medications), or other interventions for depression.
Self-help materials, telephone calls, and web-based counseling are not
separately reimbursable by Medicare and are not part of this NCD.
Screening for depression is non-covered when performed more than one
time in a 12-month period. Eleven full months must elapse following the
month in which the last annual depression screening took place. Medicare
coinsurance and Part B deductible are waived for this preventive
See link above for more information.
Melinda Brown, CMBS
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