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Medicare coverage for Depression screening


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

HCPCS code: G0444 - Annual depression screening, 15 minutes. (This code will appear on the January 2012 Medicare Physicians Fee Schedule update)

Type Of Service: 1

Place Of Service: G0444 would be covered only when services are provided at the following Places of Service (POS):

11 - Office
22 - Outpatient hospital
49 - Independent clinic
50 – FQHCs
71 - State or local public health clinic
72 – RHCs

Coverage Limitations

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 service.

Medicare will not pay G0444 separately with another encounter/visit on the same day billed on TOBs 71X or 77X. This does not apply, however, to claims with the Initial Preventive Physical Examination (IPPE) containing modifier 59 or to 77X claims containing Diabetes Self-Management Training or Medical Nutrition Training services.

Coinsurance and Deductibles

Effective October 14, 2011, beneficiary coinsurance and deductibles do not apply to claim lines with annual depression screening, G0444.

Reference: https://www.cms.gov/transmittals/downloads/R2359CP.pdf

Also see Aetna coverage guidelines for Depression screening

Also see Complete list of Screening codes effective for the year 2012

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