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Coding Guidelines for Depression Screening - CPT G0444


Reimbursement Guidelines for Depression Screening - CPT G0444

Depression screening CPT G0444 can't be coded with CPT G0402 & G0438 but you may report with CPT G0439. NCCI edits stated as "Code G0444 is a column 2 code for G0402. You may not override the edit".

Nationally Covered Indications:

CMS will cover annual screening up to 15 minutes for Medicare beneficiaries when staff-assisted depression care supports are in place to assure accurate diagnosis, effective treatment, and follow-up. 

At a minimum level, staff assisted supports consist of clinical staff (e.g., physician assistant, nurse) in the primary care setting who can advise the physician of screening results and who can facilitate and coordinate referrals to mental health treatment. Services covered under this NCD must be provided by a primary care provider.

Nationally Non-Covered Indications:

Screening for depression is non-covered when performed more than one time in a 12-month period. Also self-help materials, telephone calls, and web-based counseling are not separately reimbursable by Medicare and are not part of this NCD.

Medicare coinsurance and Part B deductible are waived for this preventive service.

Place Of Service:

Effective for claims with dates of service on and after April 2, 2012, contractors shall pay for annual depression screening claims, G0444, only when services are provided at the following Places of Service (POS)

11 Physician’s office
19 Off Campus-Outpatient hospital
22 On Campus-Outpatient hospital
49 Independent clinic 
71 State or local public health clinic

Reference: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM7637.pdf

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