New CPT Codes for Substance Abuse Screening

CHICAGO, Oct. 12 -- Two new Current Procedural Terminology (CPT) codes will allow physicians to report specific services they provide to screen and counsel patients with alcohol or drug abuse problems.

The new evaluation and management (E&M) codes -- 99408 and 99409 -- were published on Oct. 8 and will become effective on Jan. 1, 2008. Because they represent distinct services, they can be reported in addition to an E&M service code.

Codes 99408 and 99409 should be used to report a structured screening session, using "specific, evidence-based verbal, written, or electronic screening questionnaires," and a brief intervention that goes beyond a general recommendation to stop the behavior.

The choice of code depends on the time spent with the patient. The 99408 code should be used for services that take between 15 and 30 minutes, and 99409 should be reported for services lasting longer than 30 minutes.

Addition of the new codes came after a proposal from the White House Office of National Drug Control Policy to encourage care for the estimated 22 million Americans who abuse or are addicted to drugs or alcohol.

"These new codes will enable physicians to reach those in harm's way -- during a doctor's visit -- and provide them with appropriate medical services," said Bertha K. Madras, Ph.D., deputy director of the White House office.

"Screening and brief interventions can keep patients healthier, improve physicians' performance measures, and reduce hospital and healthcare costs," she said. "Implemented properly, screening and brief intervention is the most transformative substance abuse tool for medicine in decades."

The Centers for Medicaid and Medicare Services has had codes that physicians can use to report these services for Medicaid patients since Jan. 1, 2007. It is not known whether those codes will be abandoned now that there are CPT codes to cover the same services.

Also unknown is whether private insurers will reimburse for the new codes.