Date: February 1, 2018 To: Health Plan of San Joaquin (HPSJ) PCPs From: HPSJ Medical Management Department Subject: Alcohol Misuse: Screening and Behavioral Counseling Interventions Business: Medi-Cal
Consistent with United States Preventive Services Task Force (USPSTF) recommendations and the Medi-Cal Provider Manual, providers MUST annually screen adults aged 18 years or older for alcohol misuse and provide members engaged in risky drinking with brief behavioral counseling interventions to reduce alcohol misuse.
The California Department of Health Care Services (DHCS) requires the use of the following validated screening tools:
- The Alcohol Use Disorder Identification Test (AUDIT)
- The abbreviated AUDIT-Consumption (AUDIT-C), or
- A single-question screening, such as asking “How many times in the past year have you had 4 (for women and all adults older than 65 years) or 5 (for men) or more drinks in a day?”
Interventions may be delivered by face-to-face sessions, written self-help materials, computer- or Web-based programs, or telephone counseling. They may include cognitive behavioral strategies, such as action plans, drinking diaries, stress management, or problem solving.
Prior authorization is NOT needed.
The reimbursable procedure codes include:
- G0442 – Annual alcohol misuse screening, 15 minutes, one screening per year
- G0443 – Brief intervention services, 15 minutes, up to three sessions per year
Members, upon screening and evaluation, who meet the criteria for AUD as defined by the current DSM (DSM-5), are referred for further evaluation and treatment to the county department for alcohol and substance use disorder treatment services, or a California DHCS-certified treatment program.
San Joaquin County Behavioral Health Substance Abuse Services: 209-468-9600
Stanislaus Recovery Center: 209-525-7411
If you have questions about this alert, please call HPSJ UM at (209) 942-6350
Effective June 3, 2014, Walgreens became an exclusive partner with Health Plan of San Joaquin for Medi-Cal beneficiaries.
Provider Alerts - February 1, 2019