High Intensity Behavioral Counseling (HIBC) is a program that promotes the reduction or avoidance of sexual risks. It is tailored to the unique issues and needs of the patient, and includes education, skills training, and, guidance on how to change sexual behavior. It is covered for Medicare beneficiaries, who are sexually active adolescents and adults and are at increased risk for sexually-transmitted infections (STIs).
Providers determine high/increased risk sexual behavior for STIs by assessing the patient’s sexual history, specifically the areas listed below. In addition, they should consider factors such as high prevalence of STIs in community populations when determining high/increased risk for chlamydia, gonorrhea, syphilis, and in recommending HIBC.
- Multiple sex partners
- Inconsistent use of barrier protection
- Having sex under the influence of alcohol or drugs
- Having sex in exchange for money or drugs
- Having an STI within the past year;
- For men: having sex with men (MSM) and engaging in high-risk sexual behavior, regardless of their age.
- Patients 24 years of age or younger and sexually active women can specifically receive HIBC for chlamydia and gonorrhea
- IV drug users can be counseled on hepatitis B only
If the provider determines the patient is at risk, he or she can conduct up to two, 20- to 30- minute counseling sessions in one year. It’s important for providers to recognize that the counseling required goes way beyond using handouts and templates. CMS relies on the 5As model: Assess, Advise, Agree, Assist and Arrange.
September is Sexual Health Awareness Month and we thought you’d like to know that HIBC can be done via telehealth (audio only) during the public health emergency. Feel free to request our free bulletin on billing this service and be sure to check with commercial payors to see if they also cover HIBC.