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Preventive Services Guide
- Medicare Preventive Services Resource Guide
- Alcohol Misuse and Counseling
- Annual Wellness Visit Screening
- Bone Mass Measurements
- Cardiovascular Disease Screening Tests
- Colorectal Cancer Screening
- Counseling to Prevent Tobacco Use
- Depression Screening
- Diabetes Screening
- Diabetes Self-Management Training
- Glaucoma Screening
- Hepatitis B Virus Screening
- Hepatitis B Virus Vaccine and Administration
- Hepatitis C Virus Screening
- Human Immunodeficiency Virus Screening
- Influenza Virus Vaccine and Administration
- Initial Preventive Physical Examination
- Intensive Behavioral Therapy for Cardiovascular Disease
- Intensive Behavioral Therapy for Obesity
- Lung Cancer Screening Counseling and Annual Screening for Lung Cancer with Low-Dose Computed Tomography
- Medical Nutrition Therapy
- Pneumococcal Vaccine and Administration
- Prolonged Preventive Services
- Prostate Cancer Screening
- Screening for Cervical Cancer with Human Papillomavirus Tests
- Screening for Sexually Transmitted Infections and HIBC to Prevent STIs
- Screening Mammography
- Screening Pap Tests
- Screening Pelvic Examinations
- Ultrasound Screening for Abdominal Aortic Aneurysm
- Vaccinations
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Related Articles
- Medicare Preventive Services Resource Guide
- Medicare’s Annual Wellness Visit in Illinois: Understanding the Benefit and Preventing Denials
- Medicare’s Annual Wellness Visit in Minnesota: Understanding the Benefit and Preventing Denials
- Medicare’s Annual Wellness Visit in Wisconsin: Understanding the Benefit and Preventing Denials
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
- MPFS: Fee Schedule Lookup
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
- CMS IOM Publication 100-04, Medicare Claims Processing Manual,Chapter 18, Section 190
- CMS IOM Publication 100-03, Medicare National Coverage Determinations Manual, Chapter 1, Part 4, Section 210.9
- MLN® Educational Tool: Medicare Preventive Services
Reviewed 9/27/2024