PHQ 9 payment for Medicare Advantage members

When billing an Annual Wellness Visit (billable code G0439) and Patient Health Questionnaire 9 (PHQ- questions used to screen for depression, billable code G0444) on the same day for a Medicare Advantage member, the PHQ 9 is unpayable. Since the AWV includes an expectation for the PHQ 9, or other BH screening:

  • If provider bills both on the same day, the PHQ 9 would be turned back to the office as provider liability (bundles into AWV payment)
  • If provider bills PHQ 9 on a different day from AWV, the PHQ 9 charge could be applied to member out of pocket

See additional information on our behavioral health screens.