CMS Approves Medicare Coverage of Depression and Alcohol Screening in Primary Care

by Rebecca Farley on October 21, 2011

On October 14, the Centers for Medicare and Medicaid Services announced two new preventive benefits for Medicare beneficiaries: annual screening for depression as well as alcohol misuse screening and behavioral counseling.

Annual screening for depression for Medicare beneficiaries is now covered in primary care settings that have staff resources to follow up with appropriate treatment and referrals. The purpose of this screening is to assure accurate diagnosis, effective treatment and follow-up. Annual alcohol misuse screening by primary care providers, such as a beneficiary’s family practice physician, internal medicine physician, or nurse practitioner, in settings such as physicians’ offices are covered under CMS’ new policies. The benefit also includes four behavioral counseling sessions per year furnished by the primary care provider, if beneficiaries screen positive for alcohol misuse.

CMS had previously requested public comments on the new coverage proposals. The National Council’s comments urged CMS to strengthen the proposal by expanding the types of providers who may provide counseling, to include licensed behavioral health providers working in primary care. However, the final CMS decision did not incorporate these comments.

The coverage decisions on alcohol misuse screening and depression screening are available online.


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