23 Miss. Code. R. 222-1.11 - Screening, Brief Intervention, and Referral to Treatment (SBIRT) Services

A. The Division of Medicaid defines Screening, Brief Intervention, and Referral to Treatment (SBIRT) as an early intervention approach that targets pregnant women with nondependent substance use to provide effective strategies for intervention prior to the need for more extensive or specialized treatment.

B. SBIRT services must include:

1. Screening of a pregnant woman for risky substance use behaviors using evidence based standardized assessments or validated screening tools,

2. Brief intervention of a pregnant woman showing risky substance use behaviors in a short conversation, providing feedback and advice, and

3. Referral to treatment for brief therapy or additional treatment to a pregnant woman whose assessments or screenings indicate a need for additional services.

C. The Division of Medicaid covers one (1) SBIRT service per pregnancy when performed by one (1) of the following licensed practioners:

1. Physician,

2. Nurse Practioner,

3. Certified Nurse Midwife,

4. Physician Assistant,

5. Licensed Clinical Social Worker,

6. Licensed Professional Counselor, or

7. Clinical Psychologist.

D. SBIRT services provided through a Community Mental Health Center or Private Mental Health Center must be performed by one (1) of the licensed practitioners listed in Miss. Admin. Code Part 222, Rule 1.11.

E. The Division of Medicaid reimburses for SBIRT services according to Healthcare Common Procedure Coding System (HCPCS) guidelines and in accordance with applicable provider reimbursement methodologies.

1. SBIRT services provided by Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), and the Mississippi State Department of Health (MSDH) providers, are covered in the encounter rate for core services. An encounter cannot be paid solely for SBIRT services.

2. SBIRT services are not covered in an inpatient hospital setting.

F. The Division of Medicaid covers all medically necessary services for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) eligible beneficiaries in accordance with Miss. Admin. Code Part 223 without regard to service limitations and with prior authorization.

G. Providers of SBIRT services must document and maintain auditable records that meet the requirements set in Part 200, Chapter 1. Rule 1.3 including the following:

1. A copy of the evidence based standardized assessment screening tool with scoring,

2. Brief description of the intervention, and

3. Referral information.

Notes

23 Miss. Code. R. 222-1.11

42 C.F.R. §§ 440.210, 440.250; Miss. Code Ann. §§ 43-13-117, 43-13-121

New rule to correspond to SPA 17-0003 (eff. 07/01/2017) Adopted 11/1/2017