Q1: Medicare notified our group that effective 1/1/2020 they would no longer going to pay for the G0444 (depression screening) and G0443 (alcohol screening) to be performed together at the same visit. They will still pay for the two screenings but only if they are done at separate visits. Why would Medicare do this when these are clearly measures they want providers to perform?
A1: Each Medicare contractor can make certain coverage modifications. We can’t say specifically what caused them to do that. And they don't always explain themselves. There do not appear to be NCDs, LCDs and or Contractor articles on this.
That said, there have been comments made about these codes in general that might apply. See if these make sense.
"In recent years, the CMS has expanded Medicare coverage of preventive services. These services (and their corresponding Medicare billing codes) include:
- Annual alcohol misuse screening, 15 minutes (G0442)
- Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes (G0443)
- Annual depression screening, 15 minutes (G0444)
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Unfortunately, Medicare contractors have determined that insufficient documentation is causing many improper payments for these services. “Insufficient documentation” in this context means that something was missing from the medical records, such as:
- No record of the amount of time spent providing a timed service
- No record of the billed service itself
- No physician’s signature on the medical record
To avoid these potential problems, CMS advises physicians to:
- Record start and stop times, or the total time spent, when providing a timed service
- Sign entries in medical records at the time of service
It could easily be one of these concerns, perhaps in relation to audited claims, or something else entirely.
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