Depression is usually a silent illness. Sufferers of depression often don’t realize that the symptoms they are experiencing are even related to depression. Patients may notice changes in sleeping habits, experience weight gain or unexpected weight loss, or have complaints of physical pain symptoms such as back pain or headaches.
Given the diversity of depression symptoms, it is common for a patient to go to their primary care provider without realizing that their physical ailments may stem from a mental disorder such as depression. Due to this, primary care providers are well-positioned to be the first to recognize and diagnose depression in their patients.
According to the CDC, 15-20 percent of the US population aged 65 and over has experienced depression at least once in their life. Compounding the issue of depression in older Americans is chronic illness. When chronic illness and depression go hand in hand, healthcare costs are significantly increased for an already vulnerable population.
Older Americans Are Experiencing Depression at Alarming Rates
Older adults face many issues that could strain their mental health and cause them to experience depression. From losing their spouse or partner to the onset of losing their function or independence, there are many depression inducing factors typical to older demographics. By conducting regular depression screenings, primary care providers are better equipped to recognize declines in mental health even in patients who are resistant to discussing mental health issues.
According to a 2017 news release from the American Psychiatric Association, primary care providers are only conducting depression screenings for less than 5 percent of adults. Depression is severely underdiagnosed and undertreated in the US, which leaves many patients vulnerable, while financially burdening the US healthcare system.
Implementing Depression Screening in Your Practice
Primary care providers have quality and interactive relationships with their patients and are typically designated with the task of coordinating care. As a result, primary care providers are well placed to conduct regular depression screens.
The US Preventative Task Force and Medicare have identified the great benefit of depression screenings, and as such, Medicare covers a co-pay waived annual depression screening for all beneficiaries. Many private insurers have also started covering these screenings as well. Medicare has also included annual depression screenings within its MACRA/MIPS program, which means that you may be able to increase your Medicare payment modifier by implementing depression screenings in your practice.
Screening for depression in a primary care setting should be conducted using a validated instrument (such as the PHQ-9) and can be billed as a stand-alone service. Depression screening is considered ‘bundled’ within a Welcome to Medicare Physical (G0402) or Initial Annual Wellness Visit (G0438) but can be billed concurrently with a Subsequent Annual Wellness Visit (G0439).
It’s not always easy to add a new process to established clinical workflows, but as with nearly everything else, change is an important part of the growth process. Many practices screen patients for depression annually, and others base the screen on symptoms. Comprehensive wellness software can help automate these processes for depression and other behavioral health screenings. All in all, it is important to analyze what works best for your patients and your practice and develop your workflow accordingly.
So don’t allow your patients’ mental health to be overlooked, and don’t let your practice miss out on valuable reimbursement opportunities. Ensure your practice is providing this evidence-based, best-practice service to every patient that can maximize your patients’ wellbeing and your practice revenue.