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Screening,Brief Intervention or Referral to Treatment (SBIRT)

On this page, scroll down to learn about:

What is SBIRT ?

The Need for SBIRT

Efficacy of SBIRT

SBIRT Billing Codes

Common screening tools

Link to: "Screening and Brief Intervention: Making A Public Health Difference"

What is SBIRT?
Screening, Brief Intervention and Referral to Treatment (SBIRT) “…involves implementation of a system within community and/or medical settings-including physician offices, hospitals, educational institutions and mental health centers-that screens for and identifies individuals with or at-risk for substance-use related behaviors.  Screening determines the severity of substance use and identifies the appropriate level of intervention.  Options could include:

  • A brief intervention provided by the person doing the screening
  • Referral to brief treatment   
  • Referral for more extensive services (i.e. assessment, diagnosis and appropriate treatment)

The Need for SBIRT








  • Studies show that about 5% of Americans are addicted, but 25-30% misuse substances at least once/year. The misuse-not addiction-causes the bulk of injuries and related costs. Misuse of alcohol and drugs costs the American economy over $190 billion annually in lost productivity, injuries, disease, law enforcement, and criminal justice.
    Source: A Keystone to Healthcare Reform
  • Patients presenting to the ED are 1.5 to 3 times more likely to have alcohol-related problems
  • A single alcohol-related ED visit has been shown to be an important predictor of continued problem drinking, alcohol-impaired driving and possible premature death.

Efficacy of SBIRT
Research has shown that SBIRT can cut hospitalization costs by $1000.00/person screened and save $4.00 for every $1.00 invested in trauma center and emergency-room screening.

If screening is done in the ER, evidence indicates:
-Reduced alcohol consumption
-A 47% reduction in injuries requiring ED visits
-A 48% reduction in injuries requiring hospital admission
-Reduced health care costs
Source: Alcohol Screening, Brief Intervention and Referral To Treatment – Alcohol Facts

SBIRT efficacy results are further exemplified in the following examples:

1)Washington State SBIRT program showed a  substantial reduction in monthly Medicaid after receiving a screening and brief intervention...

  • Reduction in total Medicaid costs/person/month ranged from $185.00 - $192.00. Most of the savings were due to fewer days of hospitalization for visits stemming from Emergency  Department admissions.

Source: WASBIRT Medicaid Cost Outcomes  September 2007  
To get a copy of the report go to:

2)From 1999 to 2001, researchers at the Center for Adolescent Substance Abuse Research at Children's Hospital Boston refined a brief questionnaire, called the CRAFFT, that primary care physicians can use to screen for alcohol or substance abuse problems in adolescent patients.
Key Findings and Conclusions
As reported in Archives of Pediatrics & Adolescent Medicine (June 2002):
#1 The investigators found that scores on the CRAFFT screening tool were highly correlated with the other measures of substance abuse and dependence.
#2 One-fourth of the participants answered "yes" to two or more of the CRAFFT screening questions, indicating a potential substance use problem.
#3 The investigators concluded that the CRAFFT screening tool offers primary care providers a valid and practical means of quickly identifying adolescent patients who need more comprehensive assessment or referral to substance abuse treatment.

For more information on the report go to: 

SBIRT Codes for Physicians  Effective January 1, 2008  

Physicians will have four new codes (Commercial / Medicare) that can be used for Screening and Brief Intervention (SBI).  The Medicaid codes have been in effect since January 1, 2007. 

Reimbursement: At the 15-30 minute level, Medicare will pay approximately $24.05, unadjusted for geographic location; for more than 30 minutes, Medicare will pay $48.10 and private insurance could pay more.

SBIRT Tools:
A number of substance abuse screening tools have been developed. The use of instruments may vary based on State or local regulations, reimbursement policies, or personal preference.

Some of the most common tools are:




FOR MORE INFORMATION ON Screening and Brief Intervention...
Read Screening and Brief Intervention: Making  a Public Health Difference. 
To access the report go to:









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