Sept. 23, 2025
Although most people with depression can get better with the right treatment, only about 35 percent of people with severe depression get help from a mental health professional, according to the National Institute of Mental Health. Primary care providers can help our members by asking them to complete a screening and encouraging follow-up care with behavioral health care providers when appropriate.
Closing care gaps: We track the quality measure Depression Screening and Follow-Up for Adolescents and Adults from the National Committee for Quality Assurance. It measures the percentage of members ages 12 years and older who were screened for clinical depression using a standardized instrument and, if screened positive, received follow-up care within 30 days.
Who should be screened? Members who are ages 12 years and older without an active diagnosis of depression, bipolar disorder or other mood symptoms.
Who shouldn’t be screened?
- Members who have a confirmed diagnosis from a qualified physician or behavioral health clinician of depression or bipolar disorder
- Members who have had an annual depression screen or refuse to participate
- Members who are in an urgent or emergent situation where a delay in treatment may jeopardize health status
- Members whose functional capacity or motivation to improve may impact the accuracy of results, such as certain court-appointed cases or cases of delirium
A follow-up plan related to a positive screen includes one or more of the following:
- Additional evaluation for depression
- Suicide risk assessment
- Referral to a practitioner qualified to diagnose and treat depression
- Pharmacological interventions
- Other interventions or follow-up for the diagnosis or treatment of depression
Screening tools and tips
- Ask members to complete an age-appropriate depression screener during their visit, such as the Patient Health Questionnaire -9 or -2.
- Report results for informational purposes only (not reimbursement) using either procedure codes G8431 (positive screen with plan) or G8510 (negative screen) from the Centers for Medicare & Medicaid Services Adult Core Set in conjunction with standard outpatient procedure codes for the visit.
- Talk with members about the importance of following up and adhering to treatment recommendations.
- Use the same diagnosis for mental illness at follow-up visits. A non-mental illness diagnosis code will not fulfill this measure.
- Reach out to members who cancel appointments and help them reschedule as soon as possible.
Earn continuing education credit: Our introductory behavioral health webinars include a course on depression in a primary care setting. Register or sign in to attend and earn continuing education credit. Learn more.
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. References to other third-party sources or organizations are not a representation, warranty or endorsement of such organization. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.