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Behavior Health Information - Chapter 12, 2019 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 and other resources online at UHCprovider.com.

For more information on depression, alcohol use disorders, and other behavioral conditions, access the Optum website providerexpress.com. You may also email your request to BHInfo@uhc.com.

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 providerexpress.com > 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 UHCprovider.com/Policies > 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 UHCprovider.com/Policies > 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, prevention.liveandworkwell.com (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

When a member receives services from more than one care provider, collaborate and coordinate effectively to help ensure care is comprehensive, safe and effective. Lack of communication may negatively affect quality patient care. For example, members with medical illnesses may also have mental health or substance use disorders. Continuity and coordination of care is important for members with severe and persistent mental health and/or substance use disorders. This is especially true when the member is prescribed medication and has:

  • Coexisting medical/psychiatric symptoms
  • Been hospitalized for a medical or psychiatric condition

Please talk to your patients about the benefits of sharing essential clinical information.

Psychiatric and Behavioral Therapy Consults for Medical Patients

Please contact Optum if you:

  1. Want to arrange a psychiatric consultation for a member in a medical bed,
  2. Are unclear whether a behavioral health consultation is needed, or
  3. 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.