Screening and Billing for Adolescent Depression

When treating mental health, it is imperative that we include children and adolescents in our efforts to screen for depression and other mental health conditions. The American Academy of Pediatrics published, “Research shows that only 50% of adolescents with depression are diagnosed before reaching adulthood. In primary care (PC), as many as 2 in 3 youth with depression are not identified by their PC clinicians and fail to receive any kind of care.”

To ensure all Highmark Wholecare members receive the care they need, primary care providers (PCPs) should conduct a universal depression screening for adolescent patients annually, beginning at age 12.

To assist with these screenings, providers can find a list of adolescent depression screening tools on our Highmark Wholecare provider website. Patients who screen positive for a mental health condition should receive appropriate referrals and follow-up.

Billing

The recommended coding by the Pennsylvania Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Schedule and Coding Matrix:

All EPSDT screening services must be reported with age-appropriate evaluation and management code along with the EP modifier.

• 12 year to 20 year EPSDT visit CPT code is 99384 or 99394
• The CPT code suggested for Depression Screening is 96127 (brief emotional/behavioral assessment (e.g., depression inventory) with scoring and documentation, per standardized instrument).

For questions regarding the EPSDT program, feel free to contact EPSDTinfo@HighmarkWholecare.com.

These codes are not all encompassing, and use does not guarantee payment. They are intended as a guide to provide education around appropriate screenings and coding as part of the EPSDT program.