Screening, Brief Intervention, and Referral to Treatment (SBIRT)
Overview
Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an early intervention approach used to identify individuals with substance use disorders as well as those who are at risk of developing these disorders. SBIRT is used to reduce and prevent substance use disorder through the use of screening tools, brief interventions, and if needed a referral to treatment.
Eligible Providers
The following Minnesota Health Care Programs (MHCP) providers are eligible to provide SBIRT:
Eligible Members
Fee-for-service members with major program MA and MinnesotaCare are eligible for SBIRT. Providers should refer members enrolled through a managed care organization (MCO) to their MCO health plans for details on coverage and accessing SBIRT services.
Covered Services
SBIRT is a MHCP-covered service and includes any of the following when provided face to face:
Documentation of SBIRT
Documentation must support that SBIRT services were provided by a qualified provider and that the service was reasonable and necessary. Documentation must include all of the following:
Billing SBIRT
Use the following table for billing SBIRT services.
SBIRT procedure code information
SBIRT procedure code | Service description | Unit | Claim format |
G2011 | Alcohol and/or substance abuse screening and brief intervention | 5-14 minutes | 837P |
G0396 | Alcohol and/or substance abuse screening and brief intervention | 15-30 minutes | 837P |
G0397 | Alcohol and/or substance abuse screening and brief intervention | Greater than 30 minutes | 837P |
Service Limitations
SBIRT services for an individual member may be provided and billed as reasonable and necessary, up to a total of 12 sessions per individual per calendar year. The annual limit applies to any combination of the three time-based SBIRT procedure codes, regardless of service type (screening, brief intervention (BI), or referral to treatment). The 12-session allowance is primarily intended to allow for BI and referral when needed following a positive screen.
It may be appropriate to provide SBIRT services as part of other medical or behavioral health services; however, SBIRT cannot be billed at the same time as another service for the same work. SBIRT may only be billed when it is a distinct and separate service.
Substance Use Disorder Services following SBIRT
If a member’s SBIRT result indicates the member needs additional treatment, the member can choose to receive any or all of the following SUD services, up to six hours total, from an SUD provider of their choice before a comprehensive assessment:
Any of the six hours of SUD services the member chooses to receive following SBIRT must be completed within three months of the first date of SBIRT service. The program must identify in the client record an individual who is receiving SBIRT referred treatment services, including the start date and end date of services.
Billing SUD Services after SBIRT
SUD providers will need to add modifier U1 to identify the member as a SBIRT referral. There are no other changes to the billing of individual or group treatment, treatment coordination, and peer support services.
Telehealth
Providers must have documentation of services provided and have followed all clinical standards to bill for services via telehealth or telephonic (audio-only) telehealth, as applicable. Refer to the Telehealth Services section of the MHCP Provider Manual under Billing for information about billing for services provided via telehealth.
Legal References
Minnesota Statutes, 245G
Minnesota Statutes, 254A.03
Minnesota Statutes, 254B.05
Minnesota Statutes, 122A.09
Minnesota Statutes, 122A.18
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