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Behavior Health Information - Chapter 12, 2018 UnitedHealthcare Administrative Guide

The U.S. Preventive Services Task Force (USPSTF) recommends that PCPs screen patients for depression and alcohol misuse. If left untreated, these disorders can adversely affect quality of life and clinical outcomes. Screening for these disorders is critical to treatment since it can contribute to the patient’s readiness to change.

You can help by screening all patients, including adolescents. To assist, we recommend the following screenings:

  • Depression - Patient Health Questionnaire (PHQ-9)†, CPT 99420
  • Alcohol Misuse - Alcohol Use Disorders Identification Test (AUDIT) or CAGE,   CPT 99420

When doing a screening for depression in adults, remember to include the 99420 CPT Code and the ICD-10- CM Z13.89 code.

Find these screening tools for free online. You may also email your request to Optum on For more information and resources on depression and alcohol use disorders, members may access the Optum website, or go to > Clinical Resources > Clinical Tools and Quality Initiatives.

To refer a member to an Optum network care provider for assessment and/or treatment, call the toll-free number on the back of the member’s health care ID card. A link to the Optum Clinician Directory is on > Our Network > Directories.

The UnitedHealthcare Preventive Medicine and Screening Reimbursement Policy notes that counseling services are included in preventive medicine services. This policy is available on > Commercial (or Medicare Advantage Policies). The Preventive Care Services Coverage Determination Guideline is available there as well.

For information on coverage of mental health services and preventive health services for MA members, see the Medicare Advantage Coverage Summary for Preventive Health Services and Procedures, and the Medicare Advantage Coverage Summary for Mental Health Services and Procedures, available on > Medicare Advantage Policies > Coverage Summaries for Medicare Advantage Plans.

Depression, Alcohol and Drug Use Disorder and Addiction & Attention Deficit Hyperactivity Disorder (ADHD) Preventive Health Program Information

Optum has developed online preventive health resources that offer up-to-date information and tools to support treatment of major depressive disorder, alcohol and drug use disorder and attention-deficit/hyperactivity disorder (ADHD). The preventive health website, (type in the word “clinician” to enter anonymously), includes:

  • A dedicated section for physicians and other health care professionals with articles addressing aspects of each condition
  • Information about co-morbid conditions
  • Links to nationally recognized practice guidelines
  • A self-appraisal that you can print, use or refer your patients to, and
  • A listing of support resources for you, our members, and their families.

Collaboration Between Primary Physicians and Behavioral Health Clinicians

Many patients with serious medical illnesses also have mental health or substance use problems. Continuity and coordination of care are very important for patients with severe and persistent mental health and/or substance use problems. This is especially true when the member:

  • Is prescribed medication
  • Has co-existing medical/psychiatric symptoms
  • Has been hospitalized for a medical or psychiatric condition

Please talk to your patients about the benefits of sharing essential clinical information. We encourage you to obtain a signed release from each member that allows you to share appropriate treatment information with the member’s behavioral health clinician.

Psychiatric and Behavioral Therapy Consults for Medical Patients

Please contact Optum if you:

  • Want to arrange a psychiatric consultation for a member in a medical bed,
  • Are unclear whether a behavioral health consultation is needed, or
  • Want assistance with any needed behavioral health authorization.

Reach Optum by calling the phone number on the back of the member’s health care ID card.

† PHQ-9 was developed by Drs. Robert L Spitzer, Janet B.W Williams, Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc.