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Screening, Brief Intervention and Referral to Treatment (SBIRT)

An Evidence-based, Effective Method to Treat Alcohol and Drug Misuse

The U.S. Preventive Services Task Force (USPSTF) grades preventive care services for patients and gave a “B” to SBIRT. The task force's study of SBIRT suggests that screening and brief counseling interventions effectively reduce heavy drinking episodes in adults, resulting in the following:

  • Reduced alcohol consumption by 3.6 drinks per week
  • 12 percent fewer adults reported heavy drinking episodes
  • 11 percent more adults reported drinking less than the recommended limits over a 12-month period
SBIRT is endorsed by the National Council for Community Behavioral Health Care, U.S. Department of Health & Human Services, and the Substance Abuse and Mental Health Services Administration (SAMHSA).

Approved Screening Tools

Oregon Health Authority (OHA) has approved the following tools to use for SBIRT. Only screenings that use these tools meet requirements for SBIRT incentive metrics. 

  • Mental health clinics or hospitals can use one or more of these tools. 
  • Choice of screening tools must align with policies and initiatives implemented by CCOs and OHA. 


Billing Resources

SBIRT coding and billing policies vary based on payer. 

  • The Oregon Health Plan (Medicaid) covers SBIRT for all members through a wide range of provider types. 
  • Oregon providers may be eligible for SBIRT reimbursement for most of their patients.
You can find more information about SBIRT reimbursement on the SAMHSA website.

​Licensed providers:

  • Physicians 
  • Physician Assistants 
  •  Nurse Practitioners 
  •  Licensed Psychologists 
  •  Licensed Clinical Social Workers 

Under general supervision:, auxiliary providers (incident-to) 

  • Students: Medical, physician assistant, nursing; addictions, counseling, social work, psychology 
  • Medical Assistants 
  • Registered Nurses 
  • Health Educators 
  •  Wellness Coaches 
  • Qualified Mental Health Professionals & Assistants 
  •  Certified Alcohol & Drug Counselors CADCs 

All p​roviders must have SBIRT training before delivering & billing for SBIRT services.

​General principles in documentation

  • Track clinical progress toward treatment goals
  • Support the service billing / encounter 

General outline (review your own needs before implementing) 

  • Type of screen (e.g. AUDIT and/or DAST) and score 
  • How motivation was enhanced 
  • Follow-up plan • Needed referrals 

Physicians, nurse practitioners and phsycian assistants can:
  • ​Use Evaluation & Management (E&M) codes for medical appointment 
  • Use E&M codes for warm handoffs to behavioral health provider. Document SBIRT work and save CPT codes for behavioral health provider.
No Warm Handoff, use E&M and CPT codes 
  • Alcohol Screen Diagnosis + CPT Code 
  • Substance Screen Diagnosis + CPT Code 

Confidentiality, Informed Consent, and Privacy are all critical elements for adolescent services​.

​Use codes for behavioral health services.

For Warm Handoff from Medical:
  • Alcohol Screen Diagnosis + CPT ​Code 
  • ​Substance Screen Diagnosis + CPT Code 

Confidentiality, Informed Consent, and Privacy are all critical elements for adolescent services​.