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Published Date: 2025-12-11

Tobacco, Alcohol and Drug Use Assessment

Highmark Wholecare encourages providers to prioritize and integrate comprehensive pediatric screening for Tobacco, Alcohol, and Drug use to empower early identification and support for our youth.

Providers should incorporate this discussion as part of routine anticipatory guidance and conduct screenings using a validated screening tool for Tobacco, alcohol or drug use beginning at age 11 through the age of 20.

Billing

All Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services must be reported with the age-appropriate evaluation and management code along with the EP modifier.

11 year EPSDT visit CPT Code is 99383 or 99393
12 year to 17 year EPSDT visit CPT Code is 99384 or 99394
18 year to 20 year EPSDT visit CPT Code is 99385 or 99395

Providers should use 96160 Tobacco, Alcohol and Drug Use Assessment.

References:

Substance Use Screening, Brief Intervention, and Referral to Treatment | Pediatrics | American Academy of Pediatrics (aap.org)

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.