Depression Screening in Adults

This Electronic Comparative Billing Report (eCBR) focuses on physicians and practitioners who care for Medicare beneficiaries. Using claims submitted over multiple years, Palmetto GBA has identified that many Part B providers with established patients are not reporting the CPT codes associated with the performance of the Annual Wellness Visit (AWV) or Depression Screening Services for their eligible Medicare beneficiaries. Medicare contractors pay for these preventive services based on coverage and reimbursement guidelines established by the Centers for Medicare & Medicaid Services (CMS). Palmetto GBA is launching a project to better understand and ultimately help improve the performance and reporting of these services. This article shares the baseline results of our claims analysis on a jurisdictional and state level and provides access to individual practice level-information. Our goal, over the next 12 months, is to raise awareness of these covered services and increase the appropriate utilization of the respective HCPCs.

Depression isn’t part of normal aging; it often goes undetected. Untreated depression is associated with decreased quality of life, increased risk of suicide, and poor physiological outcomes when depression co-occurs with chronic medical conditions and significant life changes (e.g., loss of a spouse, etc.). Once detected, however, it is a treatable condition, and for this reason secondary prevention (screening) is recommended by the US Preventive Services Task Force – Depression in Adults: Screening and covered by the CMS National Coverage Determination 210.9 – Screening for Depression.

Screening for depression services are reported using HCPCS code G0444 (Annual Depression screening). Components of the AWV also include preventive services aimed at secondary prevention for depression, so the performance of either the Screening for Depression service (HCPCS code G0444) or the AWV will count towards the goal of increasing the appropriate utilization of evidence-based preventive services.

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Coverage and Documentation Requirements
HCPCS code G0444 is only paid annually when services are provided at the following POS:

• 11 – Office
• 22 – Outpatient Hospital
• 49 – Independent Clinic
• 71 – State or Local Public Health Clinic

Education Resources
The Provider Outreach and Education (POE) team has published an article to address the issues pertinent to this eCBR. Your practice is being encouraged and advised to review the article entitled Annual Depression Screening: HCPCS Code G0444 using one of the links below: 

• Jurisdiction J Part B article
• Jurisdiction M Part B article 

Methods
The metrics reviewed in this report are the current rates for depression screening and Annual Wellness Visit (AWV) screening for each provider compared to their own baseline rates and their individual target rates. This report is an analysis of Medicare Part B claims extracted from the Palmetto GBA data warehouse. For the purposes of this CBR, the baseline rate is defined as the screening rates for a given provider from October 2019 to September 2020 for that provider’s established patients. The target rate is the desired growth of that baseline rate over the 12-month period ending September 2021. The analysis shows the provider’s current screening rates for Depression screening and AWV screening alongside their baseline and target rate for each.