Guide to Utilizing the Screening, Brief Intervention and Referral to Treatment Model for Medicaid Practitioners

This manual has been developed to guide Medicaid practitioners in using the Screening, Brief Intervention and Referral to Treatment (SBIRT) model.  SBIRT is a public health approach to treatment which supports preventative care and the identification of health concerns early in treatment before they become chronic, acute or require deep end medical treatment, such as emergency services or hospital care.  The Agency for Health Care Administration is interested in facilitating the use of this model by Medicaid providers in physicians’ offices, and non-traditional settings.  Medicaid has existing procedure codes for physicians, County Health Departments, Rural Health Clinics and Federally Qualified Health Care Centers that can be used to follow the steps of the model. The SBIRT model is a four-part process: ⁽¹⁾

1. Universal screening globally assesses the health status of recipients seen by a practitioner for medical, mental health, or substance use conditions.
2. Brief intervention is provided when a screening indicates a moderate level of risk. Brief intervention can utilize motivational interviewing techniques focused on raising awareness of the identified health concern and its consequences and motivating the recipient toward positive behavioral change.
3. Brief therapy continues the motivational discussion for recipients needing more than a brief intervention. Brief therapy is more comprehensive and includes further assessment, education, problem solving, coping mechanisms, and building a supportive social environment.
4. Referral to treatment provides referral to a specialty care provider for persons deemed to be at high level of risk.
   

Below is a listing of procedure codes by provider type which will allow practitioners to bill Medicaid for these services at the appropriate stage within the model for recipients of any age. 

References:

⁽¹⁾ SBIRT Fact Sheet (ONDCP and SAMHSA) [940KB PDF]

Other resource material:

SAMHSA SBIRT Website

Screening, Brief Intervention, and Referral to Treatment (SBIRT) Services, January 2013 [575KB PDF]

Resource Guide: Screening for Drug Use in General Medical Settings

CAGE Substance Abuse Screening Tool [73KB PDF]

The Alcohol Use Disorders Identification Test [171KB PDF]

Systems-Level Implementation of Screening, Brief Intervention, and Referral to Treatment [4.04MB PDF]

Substance-Exposed Infants: State Responses to the Problem [1.50MB PDF]