Form 1 HCPCS Alcohol and Drug Screening and Brief Intervention

CMS Survey

Introduction

The purpose of this survey is to ascertain whether your State has adopted two new Healthcare Common Procedure Coding System (HCPCS) codes for alcohol and drug screening and brief intervention (SBI), and to determine factors that may inhibit State adoption of these codes. Substance abuse is one of our Nation’s most significant public health challenges. The National Survey on Drug Use and Health (2006) estimates that 95.5% of the population with a diagnosable substance abuse/addiction disorder is unaware of this condition and does not seek treatment.

To address this challenge and improve access to screening for this disorder, the Centers for Medicare & Medicaid Services (CMS) created two HCPCS codes – H0049 and H0050. These codes became effective January 1, 2007 and can be used by health care providers and States to pay for SBI services if State Medicaid programs choose to make SBI a covered benefit.

Survey

Please complete the following questions:

1a) Has your state turned on Medicaid Codes H0049 and H0050 for screening and brief intervention for substance abuse?

8 Yes

Please go to question 1b and then 3.

8 No

Please go to question 2.

1b) Have providers in your State submitted claims for reimbursement for these codes?

8 Yes

8 No

2) Does your state plan to turn on these two codes?

8 Yes When? _____________________

8 No What are the key factors for your State’s decision not to turn on the codes? (Please check all that apply.)

8 Did not know codes were available

8 Fiscal constraints

8 Did not want to expand substance abuse services

8 Other (Please specify)________________________

3) If your State has turned on, or plans to turn on the codes, does your State intend to conduct universal screening?¹

8 Yes (Go to question 5.)

8 No (Go to questions 4a and 4b)

4a) Since your state does not intend to conduct universal screening, do you intend to focus use of these procedural codes on specific populations? If targeting specific populations, please check all that apply below.

8 Yes

8 Patients in emergency departments and trauma centers

8 Mothers

8 Women at risk for HIV

8 Other (Please specify) _____________________________

8 No

4b) Is your state implementing these codes in a pilot program (i.e., will the codes be implemented only in designated geographic areas)?

8 Yes

8 No

5) Does your state conduct a formal assessment of substance abuse prevalence?

8 Yes

Which data source do you use?

8 National Survey on Drug Use and Health

8 State-Level Survey

8 Other (Please specify) _____________________

8 No

6) Do UPPL² laws influence the decision-making process regarding substance abuse-related services and benefits in your state?

8 Yes

8 No

7. Did CMS provide information to your State regarding the new codes?

8 Yes

8 No

7a) Was the information provided to your State helpful in understanding the new codes?

8 Yes

8 No

7b) Was the information provided to your State helpful in implementing the new codes?

8 Yes

8 No

7. If your state requested assistance from CMS in understanding and/or implementing the codes, was the information you received:

Useful to you?

8 Yes

8 No

Provided in a timely manner?

8 Yes

8 No

1 Universal screening programs target the entire population rather than focusing on specific sectors of the population.

2 Uniform Accident and Sickness Policy Provision Law (UPPL) allows insurance carriers to deny benefits to a patient whose injuries or conditions occurred when he or she was intoxicated.

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