Effective January 1, 2014, California offers a Screening, Brief Intervention, and Referral to Treatment (SBIRT) benefit to adult Medi-Cal beneficiaries. The SBIRT is to be offered annually but can be completed up to three times per year if needed, for all Medi-Cal beneficiaries, 18 years and older, in primary care settings.
The information below is required for Provider training.
What is SBIRT?
SBIRT is a comprehensive health promotion approach for delivering early intervention and treatment services to people with, or at risk of developing, alcohol use disorders.
The SBIRT benefit has three components:
- Universal screening identifies people with potential alcohol use disorders.
- Brief Intervention is provided to a beneficiary when the universal screening indicates moderate risk for an alcohol use disorder. Brief Intervention utilizes motivational interviewing techniques focused on motivating people toward positive behavioral change.
- Referral to Treatment provides a referral to specialty care for persons deemed to be at high risk for an alcohol use disorder.
A key aspect of SBIRT is the integration and coordination of screening, early intervention, and treatment components into a system of care. This system links community health care and social services programs with specialty treatment programs.
Why is SBIRT Important?
- SBIRT is effective. More than screening, SBIRT is an effective tool for identifying risk behaviors and providing appropriate intervention.
- By screening for high-risk behavior, healthcare providers can use evidence-based brief interventions focusing on health and other consequences, preventing future problems.
How does SBIRT work?
- SBIRT incorporates screening for all types of substance use with brief, tailored feedback and advice.
- SBIRT can be performed in a variety of settings. Screening does not have to be performed by a physician.
- Simple feedback on risky behavior can be one of the most important influences on patient behavior and change.
What are the benefits of SBIRT?
- Prevent disease, accidents and injuries related to substance use, resulting in better patient outcomes.
- SBIRT reduces costly healthcare utilization.
- SBIRT is reimbursable, billing codes are available (see below).
Provider Requirements & Training
Health care practitioners MUST complete the below required training in order to PERFORM and BILL for SBIRT Services.
Primary care providers (PCPs) may offer SBIRT in the primary care setting, as long as they meet the following requirements:
- SBIRT services may be provided by a licensed health care provider or staff working under the supervision of a licensed health care provider, including the following:
- Licensed Physician
- Physician Assistant
- Nurse Practitioner
- All licensed health care providers must be trained in order to provide SBIRT services or supervise individuals who provide them.
Please refer to the DHCS website link to complete the Required Training
To view the most up-to-date training and register for sessions offered by UCLA Integrated Substance Abuse Programs in our area, visit www.uclaisap.org/sbirt.
Providers who meet the requirements to screen and provide brief intervention for alcohol misuse/abuse may be reimbursed using HCPCS codes H0049 for alcohol screening and H0050 for brief interventions. These codes are reimbursable in connection with alcohol abuse only and not for drug-related services.
- A full screen, using a Medi-Cal approved screening instrument, and billed with HCPCS code H0049, is limited to one unit per recipient per year.
- Brief intervention services may be provided on the same date of services as the full screen, or on subsequent days, using HCPCS code H0050. The brief intervention is limited to three sessions per recipient per year.
Coding for SBIRT Reimbursement
Alcohol and/or drug screening
Alcohol and/or drug service, brief intervention, per 15 minutes
For more information or resources about SBIRT, please visit http://www.dhcs.ca.gov/services/medi-cal/Pages/SBIRT.aspx.