Annual Depression Screening: HCPCS Code G0444


Medicare covers annual screening for adults for depression in the primary care setting that has staff-assisted depression care supports in place to assure accurate diagnosis, effective treatment and follow-up.

Screening for depression is non-covered when performed more than one time in a 12-month period. Eleven full months must elapse following the month in which the last annual depression screening occurred. Medicare coinsurance and Part B deductible are waived for this preventive service.

Documentation should include the following:
  • Depression in older adults may exist with other illnesses including cancer, arthritis, stroke, chronic lung disease and cardiovascular disease. What disease process is present that may be an underlying factor as it relates to depression?
  • What risk factors is the patient exhibiting? Do they feel sad or empty? Less interested in daily activities? Experiencing weight loss or gain when not dieting? Decreased ability to think or concentrate? Always tearful? Experiencing feelings of worthlessness and thoughts of death or suicide?
  • Describe the type of loss if any, they are experiencing (i.e., job status/financial difficulty, death of friends or loved ones, etc.)
  • The Patient Health Questionnaire is the most common screening tool used to identify risk. Be certain to include the tool used and the findings.
  • Plan of care (POC) includes patient education and support for patient self-management. POC also pays attention to patient preferences regarding counseling, medications and referrals to mental health professionals with or without continuing involvement by the patient’s primary care physician.

Remember: Coverage is limited to screening services and does not include treatment options for depression or any diseases, complications or chronic conditions resulting from depression, nor does it address therapeutic interventions such as pharmacotherapy, combination therapy (counseling and medications).

Resource:

Centers for Medicare & and Medicaid Services (CMS) Medicare Learning Network (MLN) Matters Article 7637 (MM 7637) (PDF, 127 KB).

CMS National Coverage Determination 210.9 – Screening for Depression





Last Updated: 09/22/2020