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MedicaidCoverageMedium impact

New Substance Abuse Screening and Intervention Benefit Covered by BadgerCare Plus and Medicaid

Wisconsin Medicaid (ForwardHealth)·WI · Family Medicine, Internal Medicine, Pediatrics +2 more·Medical Policy
Effective date
Jan 1, 2010
We identified it
Jun 20, 2026
Days to comply

Summary

BadgerCare Plus and Medicaid will cover new substance abuse screening and intervention services (SBIRT) for members age 10 and older effective January 1, 2010. Providers must use approved evidence-based screening tools and complete required training to bill for these face-to-face preventive services.

Action Required

Action needed
By January 1, 2010: Billing team must update systems to bill for new SBIRT services for BadgerCare Plus and Medicaid members age 10+. Providers must complete 4-hour DHS-approved training and use approved screening tools (AUDIT, DAST, ASSIST, CRAFFT, or POSIT). Services must be face-to-face only. For pregnant members, use existing codes H0002-HF and H0004-HF instead of SBIRT benefit. Retain training documentation for staff providing these services.

Affected Billing Codes

H0002
H0004