Billing for Use of Genba Screeners


Healthcare is becoming increasingly integrated, and insurers are beginning to offer coverage for mental health screening in many different environments. For example, Medicare now provides reimbursement for depression screening in the context of an annual wellness visit or other clinical contact. Similarly, many other insurers reimburse medical providers for including mental health screening as a part of routine visits.

The CPT codes that are most often relevant for the use of Genba Assessments screening tools are 96127 or 96103. 96127 refers to brief assessment of emotional symptoms that does not require substantial integration into healthcare contact notes. 96103 refers to computerized assessment that is more formally included in a treatment plan or clinical services rendered, which usually requires both demonstration of medical necessity and significantly more documentation. If you work in an environment that routinely bills for psychological test interpretation and/or reporting, then 96101 may also be appropriate. Similarly, if you are part of an integrated setting that includes psychological assistants, behavioral health technicians, or behavioral health care managers, 96102 may be applicable. Coding and claims submission will depend on many factors, but even partial reimbursement for a fraction of patients typically more than covers the cost of Genba Assessments monthly subscription fees.