Did You Know…Medicare pays for Alcohol Mis-Use Screening & Counseling?

We all understand that mis-use of alcohol can lead to significant issues, but not many providers know that CMS will pay them to conduct a 15-minute patient screening to identify any mis-use of alcohol and, if found, to deliver up to four, brief (15 minutes each) face-to-face counseling interventions.  The alcohol screening can be accomplished in various ways but one widely used mechanism is the Alcohol Use Disorders Identification Test (AUDIT), developed by the World Health Organization.  Download a copy here.  The test can be completed by the patient or the questions can be asked of the patient and recorded.

CMS’s guidelines for a positive screening are:

Under 65

  • Women: more than 3 drinks at a time or 7 drinks per week*
  • Men: more than 4 drinks at a time or 14 drinks per week*

Over 65

  • Men & women: more than 3 drinks at a time or 7 drinks per week*

*JAMA defines a drink as 12oz beer, 5oz wine, or 1.5oz liquor.

One screening and up to four counseling sessions, reflecting the 5As, are covered per year.  Both can be delivered 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 alcohol mis-use screening and counseling.

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