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MedicaidCoverageMedium impact

Coverage for Screening, Brief Intervention, and Referral to Treatment (SBIRT) Services

Illinois Medicaid - HFS·IL · Family Medicine, Internal Medicine, Emergency Medicine +2 more·Provider Notice
Effective date
Jan 1, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Illinois Medicaid now covers Screening, Brief Intervention, and Referral to Treatment (SBIRT) services for substance use disorders for patients aged 6-64. New billing codes G2011, G0396, G0397, H0049, and G2213 are available with specific documentation and screening tool requirements.

Action Required

Action needed
Immediately: Billing team must add new SBIRT codes G2011, G0396, G0397, H0049, and G2213 to billing system for Illinois Medicaid patients aged 6-64. Providers must use AUDIT or DAST screening tools, provide face-to-face feedback, and retain screening results in clinical records. Only one SBIRT code can be billed per patient per day. Emergency departments cannot bill both SBIRT codes and G2213 simultaneously.

Affected Billing Codes

G2011
G0396
G0397
H0049
G2213