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Screening for unhealthy alcohol use
October 25, 2019

This article is for doctors and other health care practitioners who counsel our members on unhealthy alcohol use.

As of November 15, 2019, we’ll reimburse the following alcohol and substance use screening codes when these services are billed by doctors and other health care practitioners. Previously, we reimbursed these codes only when billed by behavioral health clinicians.

Who is eligible?

All members over age 18 are eligible for this benefit, but there may be differences in the member cost.

If member’s plan Then the member will
Covers routine care at zero cost (in accordance with the Affordable Care Act preventive care mandate) Pay nothing.
Does not cover routine care at zero cost Have a copay,
co-insurance, or deductible.

About the codes

The two codes are for alcohol or substance use screening (other than tobacco) and brief intervention services.

Code Time
99408 15-30 minutes
99409 More than 30 minutes

These codes include time spent:

  • Administering the screening or assessment
  • Reviewing the results
  • Counseling the patient.

The US Preventive Services Task Force recommends screening for unhealthy alcohol use for adults 18 and older, including pregnant women and those engaged in risky or hazardous drinking. These brief behavioral counseling sessions are intended to reduce unhealthy alcohol use.

Questions? 

Please contact Network Management and Credentialing Services at 1-800-316-BLUE (2583).

MPC_091919-2C-1

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