Description:
Measure 487 Social Drivers of Health measures the percentage of patients 18 years and older screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety. These particular issues could have a direct impact on the outcome of the care we provide. This is a good measure to participate in because it has podiatric implications
- If a patient is experiencing food insecurity and not receiving adequate nutrition while healing from a wound, their recovery can be impaired.
- Housing instability may lead to frequent moves, increasing the risk of losing patients to follow-up.
- Patients without reliable transportation may be unable to attend appointments and therefore may not receive the care they need.
- Utility challenges—such as lack of hot water or inability to maintain basic sanitation—can contribute to post-operative infections and wound complications.
- Concerns about interpersonal safety may prevent some patients from attending evening appointments if they feel unsafe walking through their neighborhood in the dark.
Research shows that only about 20% of health outcomes are directly linked to medical care, while the remaining 80% are influenced by socioeconomic, environmental, and behavioral factors—often referred to as the drivers of health. Issues such as homelessness, food insecurity, and exposure to partner violence are strongly associated with poorer health outcomes. These factors disproportionately affect communities of color and were significantly exacerbated during the COVID-19 pandemic.
What is the process for meeting this measure?
We look at all patients 18 years and older who have an encounter. An encounter is a patient with any of these E&M codes:
59400, 59510, 59610, 59618, 78012, 78070, 78075, 78102, 78140, 78185, 78195, 78202, 78215,
78261, 78290, 78300, 78305, 78315, 78414, 78428, 78456, 78458, 78579, 78580, 78582, 78597,
78601, 78630, 78699, 78708, 78725, 78740, 78801, 78803, 78999, 90791, 90792, 90832, 90834,
92837, 90839, 90845, 90945, 90947, 90951, 90952, 90953, 90954, 90955, 90956, 90957, 90958,
90959, 90960, 90961, 90962, 90963, 90964, 90965, 90966, 90967, 90968, 90969, 90970, 92002,
92004, 92012, 92014, 92507, 92508, 92521, 92522, 92523, 92524, 92526, 92537, 92538, 92540,
92541,92542, 92544, 92545, 92548, 92549, 92550, 92557, 92567, 92568, 92570, 92588, 92622,
92625, 92626, 92650*, 92651, 92652, 92653, 96116, 96156, 96158, 97129, 97161, 97162, 97163,
97164, 97165, 97166, 97167, 97168, 97802, 97803, 97804, 98960, 98961, 98962, 99203, 99204,
99205, 99211, 99212, 99213, 99214, 99215, 99221, 99222, 99223, 99231, 99232, 99233, 99236,
99242*, 99243*, 99244*, 99245*, 99281, 99282, 99283, 99284, 99285, 99304, 99305, 99306, 99307,
99308, 99309, 99310, 99385*, 99386*, 99387*, 99395*, 99396*, 99397*, 99401*, 99402*, 99403*, 99404*, 99411*, 99412*, 99429*, 99495, 99496, 99512*, D0120, DO140, D0145, DO150, D0160, DO170, DO180, D7111, D7140, D7210, D7220, D7230, D7240, D7241, D7250, D7251, G0101, G0108, G0136, G0270, G0271, G0402, G0438, G0439, G0447, G0473, G9054
It is important to note we do not see the 11721, 11720, 11719, or the routine foot care codes in this list. But code G0136 is present. G0136 is the CPT code specifically for Screening for Social determinants of health. So if you do the screening during an at risk foot care visit, make sure you add code G0136 to the claim and use an appropriate Z code for the diagnosis. For more information on these codes look at the Z00 series of codes as well as the Z55 - Z65 codes when using this billing code.
Other important factors:
- If you screen a patient for social drivers of health and they decline or refuse to complete the survey, this will not count against you, but this must be documented and that patient becomes an exception for this measure. The reporting code for this is M1237
- If you fail to offer the survey or do not conduct the screening at all, it will be counted against you, the reporting code is M1208..
- The measure is met if the patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety. The reporting code for meeting this measure is M1207.
It is important to use a validated screening tool when documenting this encounter.
CMS has published a guide on screening tools which can be found at A Guide to Using the Accountable Health Communities Health-Related Social Needs Screening Tool: Promising Practices and Key Insights
The benchmarks for fhis measure for 2025 are very favorable and a performance of just 62% will get you 7 points on this measure, To get 8 ponts you must be at 99.1% or higher and 100% will earn you a full 10 points for this measure
If you find that you did not do this during the office visit this can be done over the telephone or via telehealth.
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