Current through Register Vol. 35, No. 18, September 24, 2024
SBIRT is a community-based practice designed to identify,
reduce and prevent problematic substance use or misuse and co-occurring mental
health disorders as an early intervention. Through early identification in a
medical setting, SBIRT services expand and enhance the continuum of care and
reduce costly health care utilization. The primary objective is the integration
of behavioral health with medical care. SBIRT is delivered through a process
consisting of universal screening, scoring the screening tool and a warm
hand-off to a SBIRT trained professional who conducts a face-to-face brief
intervention for positive screening results. If the need is identified for
additional treatment, the staff member will refer to behavioral health
services. See Subsections A and B of
8.321.2.9
NMAC for MAD general provider requirements.
A.
Eligible providers and
practitioners:
(1) Providers may
include:
(a) primary care offices including
FQHCs, IHS 638 tribal facilities and any other "Indian Health Care Provider
(IHCP)" defined in 42 Code of Federal Regulations §438.14(a);
(b) patient centered medical homes;
(c) urgent care centers;
(d) hospital outpatient facilities;
(e) emergency departments;
(f) rural health clinics;
(g) specialty physical health
clinics;
(h) school based health
centers; and
(i) nursing
facilities.
(2)
Practitioners may include:
(a) licensed nurse
trained in SBIRT;
(b) licensed
nurse practitioner or licensed nurse clinician trained in SBIRT;
(c) behavioral health practitioner trained in
SBIRT;
(d) certified peer support
worker trained in SBIRT;
(e)
certified community health worker trained in SBIRT;
(f) licensed physician assistant trained in
SBIRT;
(g) physician trained in
SBIRT;
(h) home health agency
trained in SBIRT
(i) nurse home
visit EPSDT;
(j) medical assistant
trained in SBIRT; and
(k) community
health representative in tribal clinics trained in SBIRT.
B.
Coverage
Criteria:
(1) screening shall be
universal for recipients being seen in a medical setting;
(2) referral relationships with mental health
agencies and practices are in place;
(3) utilization of approved screening tool
specific to age described in the BH policy and billing manual;
(4) all participating providers and
practitioners are trained in SBIRT through state approved SBIRT training
entities. See details in the BH policy and billing manual.
C.
Identified population:
(1) MAD recipient adolescents 11-13 years of
age with parental consent;
(2) MAD
recipient adolescents 14-18 years of age;
(3) MAD recipient adults 19 years and
older.
D.
Covered
services:
(1) SBIRT screening with
negative results eligible for only screening component;
(2) SBIRT screening with positive results for
alcohol, or other drugs, and co-occurring with depression, or anxiety, or
trauma are eligible for:
(a) screening;
and
(b) brief intervention and
referral to behavioral health treatment, if needed.
E.
Reimbursement:
(1) Screening services do not require a
diagnosis; brief interventions can be billed with a provisional
diagnosis.
(2) See BH policy and
billing manual for coding and billing instruction.
