assessment standardized screening tool is recommended. Strengths and Difficulties Questionnaire (SDQ) Ages and Stages Questionnaire – Social Emotional (ASQ-SE) Early Childhood Screening Assessment be billed only when a standardized screening tool is used and results documented 96127 may be combined with other screening codes (ex. 96110) for a maximum of 2 units of screening per visit Depression screening Screening recommended annually beginning at 11 years of age. If providers choose, they can “pre-screen” with PHQ-2 to determine if a longer standardized screening tool is needed. PHQ-9 Modified for Teens Pediatric Symptom Checklist (PSC-Y) Center for Epidemiological Studies Depression Scale for Children (CES-DC) Beck Depression Inventory (BDI) 96127: Brief emotional/ behavioral assessment may be billed only when a standardized screening tool is used and results documented. PHQ-2 may not be billed. A maximum of 2 units of 96127 will be reimbursed per visit; OR 96127 may be combined with other screening codes (ex. W7000) for a maximum of 2 units of screening per visit Substance use assessment Annually beginning at 11 years of age; use of brief screening tool is recommended. Positive screens should be followed by brief intervention and referral for treatment when indicated (SBIRT: Screening, Brief Intervention, and Referral to Treatment) CRAFFT CAGE-AID W7000: Alcohol and/or substance use disorder screening may be billed only when a standardized screening tool is used and results documented. W7020: Intervention; > 3 minutes up to 10 minutes W7021: Intervention; >10 minutes up to 20 minutes W7022: Intervention; >20 minutes A maximum of 1 unit of W7000 will be reimbursed annually for recipients age 11 and up W7000 may be combined with other screening codes (ex. 96127) for a maximum of 2 units of screening per visit A maximum 4 interventions will be reimbursed annually per recipient age 11 and up
Table 6. 2. Other Pediatric Mental Health Screening/Assessments Recommendation Examples of Acceptable Standardized Tools Billing Guidelines Limitations ADHD Assessment AAP clinical policy recommends use of parent and teacher ratings scales as a component of screening/diagnosis when there is concern Vanderbilt ADHD Diagnostic Rating Scales – Parent and Teacher Conners-3 Ratings Scales ADHD Rating Scale-5 for Children and Adolescents 96127: Brief emotional/ behavioral assessment may be billed only when a standardized screening tool is used and results documented. A maximum of 2 units of 96127 will be reimbursed per visit Other mental health screening/ assessment Disorder-focused mental health screening and assessment tools may be used when there is a specific concern, ex. anxiety Screen for Childhood Anxiety Related Disorders (SCARED) Spence Children’s Anxiety Scale 96127: Brief emotional/ behavioral assessment may be billed only when a standardized screening tool is used and results documented. A maximum of 2 units of 96127 will be reimbursed per visit ADHD Assessment AAP clinical policy recommends use of parent and teacher ratings scales as a component of screening/diagnosis when there is concern Vanderbilt ADHD Diagnostic Rating Scales – Parent and Teacher Conners-3 Ratings Scales ADHD Rating Scale-5 for Children and Adolescents 96127: Brief emotional/ behavioral assessment may be billed only when a standardized screening tool is used and results documented. A maximum of 2 units of 96127 will be reimbursed per visit Other mental health screening/ assessment Disorder-focused mental health screening and assessment tools may be used when there is a specific concern, ex. anxiety Screen for Childhood Anxiety Related Disorders (SCARED) Spence Children’s Anxiety Scale 96127: Brief emotional/ behavioral assessment may be billed only when a standardized screening tool is used and results documented. A maximum of 2 units of 96127 will be reimbursed per visit