Screening, Brief Intervention and Referral for Treatment (SBIRT)
Screening for substance abuse, including alcohol, illegal drugs, and prescription medications, should be a regular part of health care,
You could help identify an addiction problem early, which could help get your patient into treatment early. The potential for drug and alcohol misuse is everywhere — in our homes, our schools, our workplaces, and our communities. Talk with your patients. They’ll listen to you.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), SBIRT is a comprehensive, integrated, public health approach to the delivery of early intervention and treatment services for persons with substance use disorders, as well as those who are at risk of developing these disorders.
- Screening: Universal screening using a brief, validated questionnaire to determine the use and severity of alcohol, illicit drug use, and prescription drug use to inform the appropriate intervention level. No blood or urine test is administered.
- Brief intervention: Brief motivational and awareness-raising intervention given to those whose substance use is putting their health and well-being at risk (5 to 30 minutes). The intervention is performed on-site following the screening. Offer medication for substance use disorder assisted treatment options.
- Referral to treatment: Referral to specialty care for patients with high-risk substance use (and patients with a possible substance use disorder). The practitioner helps patients access specialized treatment, select treatment facilities, and obtain authorizations from insurance. After a referral is made, follow-up phone calls with the patient or treatment staff are part of the collaboration to help ensure care.
According to several credible research studies, yes! SBIRT’s efficacy, including comprehensive data on individual health outcomes and cost-saving measures have been published. SBIRT has been shown to:
- Decrease harmful alcohol use by 39% and lower illicit drug use by 68%.
- Decrease overall health care costs by reducing emergency department (ED) visits and inpatient admissions.
- Decrease rates of arrest, homelessness, and mental health problems.
- Increase rates of employment and improve general health.
The model begins with a focus on risk and targets individuals at risk for developing a substance use disorder. SBIRT focuses on opportunities to educate individuals about hazardous use while helping them to reduce or dismiss it.
- Conduct screening ―choose an appropriate tool.
- Determine level of risk
- 20% of patients screened will be classified as moderate- to high-risk and require a brief intervention.
- 5% of patients will be found to have severe risk or dependency and will need a referral to specialty treatment.
- 75% will include abstainers and low-risk alcohol users who will simply require positive reinforcement for continuing to abstain, or to reduce use further.
SBIRT billing codes
The codes are applicable to fee-for-service and managed care. At this time, only physicians and physician extenders can render SBIRT services. This includes the following provider types:
- 25 — MD
- 26 — DO
- 29 — PA
- 30 — APRN
As any of these provider types, you can be reimbursed for SBIRT based on the table below.
| Medicaid | Code | Description | Fee schedule |
|---|---|---|---|
| H0049 | Alcohol and/or drug screening | $24.00 | |
| H0050 | Alcohol and/or drug screening, brief intervention, per 15 minutes | $48.00 |
Learn more about screening for depression.
Learn more about screening for alcohol and substance use disorder.