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Date
2015-04-02
Title
Screening and Counseling to Reduce Alcohol Misuse
Topic
Alcohol Awareness Month and National Alcohol Screening Day

Screening and Counseling to Reduce Alcohol Misuse

April is Alcohol Awareness Month and April 9 is National Alcohol Screening Day – People who drink too much alcohol increase their risk of injuries, violence, drowning, liver disease, and even some types of cancer. Seniors and others covered by Medicare can be screened for alcohol misuse under the Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse benefit. This April, during Alcohol Awareness Month and National Alcohol Screening Day, CMS encourages you to talk with your Medicare patients and their care givers about the dangers of drinking too much, and when appropriate, encourage utilization of the Medicare-covered screening and counseling service to reduce alcohol misuse.

Medicare Coverage

Medicare provides coverage for Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse for eligible beneficiaries who, if determined by a primary care physician or other primary care practitioner, may need help in reducing or abstaining from alcohol consumption.

  • Medicare covers an annual alcohol screening.
  • For those who screen positive, Medicare will cover and up to four, brief face-to-face behavioral counseling interventions per year for Medicare beneficiaries, including pregnant women:
  • Who misuse alcohol, but whose levels or patterns of alcohol consumption do not meet criteria for alcohol dependence (defined as at least three of the following: tolerance, withdrawal symptoms, impaired control, preoccupation with acquisition and/or use, persistent desire or unsuccessful efforts to quit, sustains social, occupational, or recreational disability, use continues despite adverse consequences); and
  • Who are competent and alert at the time that counseling is provided; and,
  • Whose counseling is furnished by qualified primary care physicians or other primary care practitioners in a primary care setting.

The Medicare coinsurance and Part B deductible are waived for this preventive service.

For the full indications and limitations of coverage review the National Coverage Determination (NCD) for Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse in the Medicare coverage database.

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