Education & TrainingBadgerCare Plus and Medicaid SSI ProgramsSeptember 12, 2023

SBIRT: Improving patients’ lives

What is screening, brief intervention, and referral treatment (SBIRT)?

SBIRT is an evidence-based approach to identifying patients who use alcohol and other drugs at dangerous levels. The goal of SBIRT is to reduce and prevent related health consequences, disease, accidents, and injuries. Risky substance use is a health issue that often goes undetected. By incorporating this evidence-based tool demonstrated to be reliable in identifying individuals with risk for a substance use disorder, significant harm can be prevented.

SBIRT can be performed in a variety of settings. Screening does not have to be performed by a physician. SBIRT incorporates screening for all types of substance use with brief, tailored feedback, and advice. Simple feedback on risky behavior can be one of the most critical influences on changing patient behavior.

Why use SBIRT?

  • SBIRT is an effective tool for identifying risk behavioral and providing appropriate intervention.
  • By screening for high-risk behavior, healthcare providers can use evidence-based brief interventions focusing on health and consequences, preventing future problems.
  • Brief intervention focuses on increasing insight and awareness regarding substance use and motivation toward behavioral change.
  • Referral to treatment provides those identified as needing more extensive treatment with access to specialty care.
  • SBIRT reduces costly healthcare utilization.
  • SBIRT is reimbursable through Medicaid.
  • SBIRT is appropriate for any patient, regardless of age, gender, or health status.

When we say… 

We mean… 

Screening 

  • Provide a short, structured consultation to identify the right amount of treatment. 
  • Use common screening tools such as AUDIT, ASSIST, DAST-10, CRAFT, and TWEAK.

Brief intervention 

  • Educate patients and increase motivation to reduce risky behavior. 
  • Brief education intervention increases motivation to reduce risky behavior. 
  • Typically 5 to10 minutes

Brief treatment 

  • Fulfill goals of:
    • Changing the immediate behavior or thoughts about a risky behavior. 
    • Addressing longstanding problems with harmful drinking and drug misuse. 
    • Helping patients with higher levels of disorder obtain more long-term care.
  • Typically 5 to12 minutes

Referral to treatment 

  • If a patient meets the diagnostic criteria for substance dependence or other mental illnesses as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, we recommend you refer them to a specialty provider. 

Who delivers SBIRT services?

Implementing SBIRT into care management — screening tools

There are multiple screening tools to use for different populations. Anthem Blue Cross and Blue Shield recommends the following screening tools for their brief nature, ease of use, flexibility for multiple types of patients, and indication of need for further assessment or intervention:

Screening Tool

Age Range or Population

Overview

Alcohol Use Disorder Identification Test (AUDIT)

All patients

Developed by the WHO. Appropriate for all ages, genders, and cultures

Alcohol, Smoking, and Substance Abuse Involvement Screen Test (ASSIST)

Adults

Simple screener for hazardous use of substances (including alcohol, tobacco, other drugs)

Drug Abuse Screening Test (DAST-10)

Adults

Screener for drug involvement, does not include alcohol, during last 12 months

Car, Relax, Alone, Forget, Family or Friends, Trouble (CRAFFT)

Adolescents & Children

Alcohol and drug screening tool for patients <21. Recommended by American Academy of Pediatrics. 

Screening to Brief Intervention (S2BI) 

Adolescents 

Assesses frequency of alcohol and substance

NIAAA Alcohol Screening for Youth

Pregnant women

Four-item scale to assess alcohol use in pregnant women; recommended for OB/GYNs

Tolerance, Annoyance, Cut Down, Eye Opener (T-ACE)

Pregnant women

Five item scale to screen for risky drinking during pregnancy

Tolerance, Worried, Eye Opener, Amnesia, K/Cut Down (TWEAK)

Pregnant Women

Five item scale to screen for risky drinking during pregnancy

Getting reimbursed?

CPT Code 

Code description

H0049

SBIRT: Alcohol and/or drug screening

H0050

SBIRT: Alcohol and/or drug services, brief intervention, per 15 minutes

Need help with a referral to a behavioral health specialist?

Referrals can be complex and involve coordination across different types of services — we can help. Call Provider Services at 855-558-1443. We’re glad to help you get our members this important kind of care.

Sources:

  1. Screening, Brief Intervention and Referral to Treatment (SBIRT) in Behavioral Healthcare, 4/1/2019, www.SAMHSA.gov.
  2. Alcohol Screening and Brief Intervention: A Guide for Public Health Practitioners, American Public Health Association, page 8.

WIBCBS-CD-037407-23

PUBLICATIONS: October 2023 Provider Newsletter