2025 HCPCS code G8431
(Active) Effective Date: N/A Revision Date: N/A Preventive Services - Depression Screening Additional Quality Measures Feed
Screening for depression; documented as positive with a follow-up plan.
Modifiers may apply depending on circumstances, such as the place of service or the type of provider involved in the screening and treatment planning.Check the payer's guidelines and local coding conventions.
Medical necessity is established by the presence of symptoms suggestive of depression, as documented in the patient's chart, warranting a screening and subsequent follow-up plan. The severity of symptoms may guide the intensity of the treatment plan.
The clinical responsibility lies with the physician or qualified healthcare professional who performs the depression screening, assesses the results, and develops and documents the follow-up treatment plan.
In simple words: This code is used when a doctor checks a patient for depression, finds signs of depression, and creates a plan to help the patient.
This HCPCS code reports a positive screening result for clinical depression in a patient, along with documentation of a subsequent treatment plan.The treatment plan may involve additional evaluation, suicide risk assessment, referral to a specialist, medication management, or other appropriate interventions.This code should only be used when a positive screening for depression is documented and a follow-up treatment plan is established.
Example 1: A primary care physician screens a 15-year-old patient using a standardized tool (e.g., PHQ-9) and identifies positive indicators of depression.A follow-up plan is documented, including referral to a mental health specialist., A pediatrician screens a 12-year-old patient for depression during a routine checkup. The screening reveals positive results, prompting the pediatrician to initiate a treatment plan that includes regular monitoring, counseling referrals, and parental education., A psychiatrist uses a standardized assessment tool to screen for depression in a new patient exhibiting symptoms of depression.A positive result leads to the development of a comprehensive treatment strategy encompassing therapy, medication management, and ongoing monitoring.
* Positive screening results from a validated depression screening tool (e.g., PHQ-9, EDPS, BDI).* Detailed documentation of the follow-up treatment plan, including specific interventions and the rationale for their selection.* Patient demographics and relevant medical history.* Provider's signature and date.
** This code is specifically for documenting a positive screening result and a subsequent treatment plan.A separate code (G8510) exists for negative screening results.
- RVU: Reimbursement varies by payer; refer to your specific contract.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule : Reimbursement rates vary by payer and are subject to change. Consult your payer's fee schedule.
- Specialties:Primary Care, Pediatrics, Psychiatry, Family Medicine
- Place of Service:Office, Outpatient Hospital, Clinic