Preventive Services

Preventive Services Guide


Depression Screening

Also Known as Screening for Depression in Adults

Coverage Criteria

  • Covered annually
    • At least 11 months must have passed since last depression screening
  • G0444: Annual depression screening, 15 minutes
  • No specific diagnosis code required

Covered Places of Service

  • Must be performed in primary care setting with staff-assisted depression care supports
  • Minimal level supports, clinical staff in primary care office who can advise physician of screening results, and facilitate/coordinate referrals to mental health treatment
  • Covered as Medicare telehealth service

Primary Care Settings Defined

  • Office - 11
  • Off Campus- outpatient hospital - 19
  • Outpatient hospital - 22
  • Independent clinic - 49
  • State or local public health clinic - 71

Cost Sharing

  • Copayment/coinsurance waived
  • Deductible waived

Reimbursement

Nonparticipating Providers

  • Nonparticipating reduction applies
  • Limiting charge provision applies

Billing Tips

  • Cannot be billed on the same day as IPPE or first AWV
  • Medical records must document all coverage requirements
  • Coverage does not include:
    • Treatment options for depression or any diseases, complications or chronic conditions resulting from depression
    • Therapeutic interventions such as pharmacotherapy, combination therapy (counseling and medications)
    • Other interventions for depression
    • Self-help materials
    • Telephone calls
    • Web-based counseling

Common Claim Denials

  • Patient received more than one screening for depression in last 12 months
  • Patient received screening for depression on same day as IPPE or first AWV
  • Patient received screening for depression outside of primary care setting

Related Content

Reviewed 9/27/2024