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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)
Source:
www.sbirt.samhsa.gov
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.
Source:
www.jointogether.org/news/features/2009/taking-burden-off-physicians.html?pirnt=t
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:
http://www1.dshs.wa.gov/RDA
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:http://www.rwjf.org/reports/grr/036126.htm
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 YOUTH:
FOR ADULTS:
FOR MORE INFORMATION ON Screening
and Brief Intervention...
Read Screening and Brief Intervention: Making a Public
Health Difference.
To access the report go to:
www.jointogether.org/resources/2009/screening-and-brief.html
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