Current Effective Date:
11/10/2016
Prenatal SBIRT
The Screening, Brief Intervention, and Referral to Treatment (SBIRT) pilot project is an effective evidence-based public health approach for reducing risky behavior related to substance misuse. Any Medicaid-contracted obstetrician who is not practicing in a federally qualified health center who provides prenatal care and has undergone SBIRT training provided by Hilopa’a Family to Family Health information Center can be paid separately for SBIRT interventions addressing alcohol, drug and/or tobacco misuse.
This payment is separate from the reimbursement for prenatal care and can only be made to providers who have completed the SBIRT training with Hilopa’a. Obstetricians who are interested in obtaining SBIRT training should contact Hilopa’a at training@hilopaa.org.
Reimbursable screening and brief intervention codes include:
| Reimbursement Codes* | Diagnosis Codes** | |||
|---|---|---|---|---|
| Alcohol and/or Drug | Smoking | |||
| Screening & Brief Intervention |
G0396 15 to 30 minutes |
99406 3 to 10 minutes |
Alcohol use | O99.31- |
|
G0397 greater than 30 minutes |
99407 greater than 10 minutes |
Drug use | O99.32- | |
| Smoking | O99.33 | |||
| Providers may also report other non-reimbursable diagnosis such as: | Abuse physical | O9A.31- | ||
| Abuse psychological | O9A.51- | |||
| Abuse sexual | O9A.41- | |||
| Mental disorder | O99.34- | |||
*SBIRT codes will pay separately when combined with any obstetrical codes.
**The diagnosis codes start with the letter O and not the number 0.
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform. |