Reimbursement Guidelines For Depression Screening
Nationally Covered Indications For CPT G0444
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 For CPT G0444
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 Code (POS) For CPT G0444
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):
- POS 11: Physician’s office19 Off Campus-Outpatient hospital
- POS 22: On Campus-Outpatient hospital
- POS 49: Independent clinic
- POS 71 :State or local public health clinic