The Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is adequate to conclude that screening for depression in adults, which is recommended with a grade of B by the U.S. Preventive Services Task Force (USPSTF), is reasonable and necessary for the prevention or early detection of illness or disability and is appropriate for individuals entitled to benefits under Part A or enrolled under Part B.
Full Answer
Are there screening tools for the evaluation of depression in the elderly?
Colasanti and colleagues performed a systematic review of screening tools for the evaluation of depression in the elderly. Since symptoms of depression in the elderly can be difficult to identify and interpret, diagnosing depression can be difficult in the elderly, especially when concomitant pathologies mask signs and symptoms of depression.
What is the brief depression screening toolkit?
The Brief Depression Screening Toolkit developed by the Behavioral Health Workgroup of the Patient Centered Primary Care Collaborative. This includes a description of the benefit, a copy of PHQ-9, and treatment considerations based on the results of the screening tool.
Is there a gold standard for depression screening?
There is no gold standard for depression screening, and the USPSTF states that “clinicians may choose the method most consistent with their personal preference, the patient population being served, and the practice setting.”
Does CMS cover annual screening for depression?
Therefore CMS will cover annual screening for depression for Medicare beneficiaries in primary care settings that have staff-assisted depression care supports in place to assure accurate diagnosis, effective treatment and follow-up. For the purposes of this decision memorandum:
What depression screening tool does Medicare require?
The Patient Health Questionnaire (PHQ-9) is the most frequently used screening measure in the primary care setting. This nine-question, self-administered survey can be completed by the patient in the waiting room and then quickly scored by staff before the patient sees the physician.
What is the Medicare patient's responsibility for one depression screening a year?
Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services. covers one depression screening per year.
Is PHQ-9 required?
Who can use the PHQ 2 and 9? The PHQ 2 and 9 are both publicly available, and no permission is required to use, reproduce, or distribute the tools.
What screenings are used for depression?
The PHQ-9 is a valid, quick screening instrument for depression that also can be used as a follow-up to a positive PHQ-2 result and to monitor treatment response. Depression screening in older adults can be accomplished with multiple instruments, including the PHQ-2, PHQ-9, and various Geriatric Depression Scales.
Can you bill depression screening with annual wellness visit?
Depression Screening This screening can be performed annually, but it cannot be billed when performed with the initial AWV.
How do you bill for depression screening?
You should report CPT code 96127, “Brief emotional/behavioral assessment (e.g., depression inventory, attention-deficit/hyperactivity disorder [ADHD] scale), with scoring and documentation, per standardized instrument,” with one unit for each screening instrument completed, and be sure to document the instruments used ...
What is the difference between PHQ-9 and PHQ A?
The benefit of using the PHQ-A is its development for an adolescent population and inclusion of a question about suicidal ideation and suicide attempts. Although it was not designed specifically for adolescents, the PHQ-9 is the current standard depression screening instrument for adults in LVPG primary care.
When should I use PHQ-9?
The PHQ-9 is a simple, nine question form used to screen depression and monitor changes in signs/symptoms of depression. The patient's PHQ-9 score should be recorded at the beginning of a visit, like blood pressure or other vitals.
What is the difference between PHQ-2 and PHQ-9?
PHQ-9 items reflect the 9 DSM symptoms of major depression; PHQ-2 items reflect depressed mood and anhedonia. We prioritized major depressive episode over major depressive disorder, if both were provided, because screening attempts to detect episodes, and we prioritized DSM over ICD.
What is an annual depression screening?
The annual depression screening includes a questionnaire that you complete yourself or with the help of your doctor. This questionnaire is designed to indicate if you are at risk or have symptoms of depression.
What is the most commonly used measure of depression?
The Hamilton Depression Rating Scale is the most widely used interview scale, developed in 1960 to measure severity of depression in an inpatient population.
What are mental health assessment tools?
Assessment tools are standardised systems that help to identify and gauge the extent of specific conditions and provide a fair approach in response. They can be the means whereby individual and particular assessments contribute to the overall picture.
What is an IPPE in Medicare?
Initial Preventive Physical Examination (IPPE) The IPPE, known as the “Welcome to Medicare” preventive visit, promotes good health through disease prevention and detection. Medicare pays for 1 patient IPPE per lifetime not later than the first 12 months after the patient’s Medicare Part B benefits eligibility date.
How many times can you report ACP?
There are no limits on the number of times you can report ACP for a certain patient in a certain time period. When billing this patient service multiple times, document the change in the patient’s health status and/or wishes regarding their end-of-life care. Preparing Eligible Medicare Patients for the AWV.
How long does Medicare cover AWV?
Medicare covers an AWV for all patients who aren’t within 12 months after the eligibility date for their first Medicare Part B benefit period and who didn’t have an IPPE or an AWV within the past 12 months. Medicare pays for only 1 IPPE per patient per lifetime and 1 additional AWV per year thereafter.
Does Medicare waive ACP deductible?
Medicare waives the ACP deductible and coinsurance once per year when billed with the AWV. If the AWV billed with ACP is denied for exceeding the once-per-year limit, Medicare will apply the ACP deductible and coinsurance. The deductible and coinsurance apply when you deliver the ACP outside of the covered AWV.
What is included in a PCP wellness visit?
This may include a questionnaire that you complete before or during the visit.
Does Medicare require a cognitive test?
Screen for cognitive impairment, including diseases such as Alzheimer’s and other forms of dementia. Medicare does not require that doctors use a test to screen you. Instead, doctors are asked to rely on their observations and/or on reports by you and others. Screen for depression.
Does Medicare require a PCP to screen you?
Your PCP should keep in mind your health status, screening history, and eligibility for age-appropriate, Medicare-covered preventive services. Medicare does not require that doctors use a test to screen you.
Does Medicare cover wellness visits?
If you qualify, Original Medicare covers the Annual Wellness Visit at 100% of the Medicare-approved amount when you receive the service from a participating provider. This means you pay nothing (no deductible or coinsurance ).
Decision Summary
The Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is adequate to conclude that screening for depression in adults, which is recommended with a grade of B by the U.S.
Decision Memo
The Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is adequate to conclude that screening for depression in adults, which is recommended with a grade of B by the U.S.
What is Medicare annual wellness visit?
What is the Medicare Annual Wellness Visit? When you attend Medicare annual wellness visit, your physician will have you complete a “Health Risk Assessment”. This is a fancy term for a health questionnaire.
How often is a wellness visit required for Medicare?
This is only once, within your first 12 months of Part B. As discussed above, the Medicare Annual Wellness Visit is an exam that you receive if you’ve been a Medicare recipient for more than 12 months, and this appointment is once per year. The Annual Wellness Visit is a health evaluation, rather than a physical examination.
How long do you have to carry Medicare Part B?
Your annual visit coverage is under your Medicare Part B. You should be aware that you must carry Part B for more than 12 months to qualify for this visit.
Does Part B depend on wellness?
No, your Part B doesn’t depend on you attending your Annual Wellness Visit. Although the visit is a free preventive visit that you should go to, it’ll help you stay on track to living a healthy lifestyle.
Can you get an annual wellness visit with Medicare?
The Annual Wellness Visit is a health evaluation, rather than a physical examination. Furthermore, you can’t receive an AWV during the same calendar year as your Welcome to Medicare preventative visit.
What is a standardized depression screening test?
Using a standardized depression screening test (such as these provided via the Substance Abuse and Mental Health Services Administration), review a beneficiary's potential risk factors for depression. This should include current or past experiences with depression or other mood disorders. Functional ability and safety.
What is the documentation required for a Medicare wellness visit?
The documentation requirements for the initial Medicare annual wellness visit are as follows: Health risk assessment. The health risk assessment (HRA) must be completed by a beneficiary or healthcare provider before or during the annual wellness visit encounter. At a minimum, the HRA should include demographic data;
What is Medicare AWV?
In addition, the Medicare AWV is an opportunity for patients to meet with providers who can also deliver or schedule preventive services, such as vaccinations and cancer screenings.
How long does a provider have to produce a preventive screening plan?
Providers are expected to produce a written preventive screening and services plan for the beneficiary's next 5-10 years. This is an integral part of the personalized prevention plan of service (PPPS).
Does Medicare waive video?
Furthermore, in late April, Medicare waived the video requirements to permit telephone-only telehealth for many services , including the AWV. Physicians that choose to provide the AWV virtually, either via video or audio, must still complete all documentation requirements. To help ensure your patients receive the best Medicare annual wellness visit ...