WIPHL Clinical Studio
WI 2006-2016 SBIRT · 110,000+ Clinical Screens

Calm Bedside SBIRT & Standard Drink Calibration

One 16 oz craft pint or generous wine pour often carries nearly two U.S. standard drinks. Calibrate real pours against 14g ethanol equivalents, see weekly sleep and blood pressure impacts, and step cleanly into EMR-ready SBIRT charting.

14g Pure ethanol per U.S. standard drink
110,000+ WI primary care & ED screens
99408 15-30 min CPT / G0396 ready
Open 3-Step SBIRT Wizard Protocol & CPT Guide

What's in Your Pour?

Select a glass to calibrate exact 14g ethanol equivalents and weekly health load.

2.0 Std Drinks · 28g Ethanol
Interactive Standard Drink Beverage Vessel Calibration 2.0x 1.5x 1.0x 0.5x
One 16 oz 7.5% craft pint = 2.0 standard drinks (28g ethanol).
Pours / Week
4 pours/wk
NIAAA Low-Risk Benchmark
8.0 Std Drinks/wk · 112g ethanol Above <=7/wk Limit
0 NIAAA Low-Risk Limit: <=7/wk 21+/wk

Sleep & BP: ~14-18% REM sleep depth loss on drinking nights and +2 to +4 mmHg systolic BP elevation. Consider alcohol-free days.

Clinician Bedside Workflow

3-Step SBIRT Screening, Readiness & EMR SOAP Studio

Step cleanly through validated AUDIT-C and DAST-10 scoring, readiness-matched FLO prompts, and time-attested CPT 99408/G0396 charting with zero browser telemetry.

Quick Case:
AUDIT-C 6/12 · DAST-10 1-2/10 · Ready 5/10 Hazardous / Moderate Risk
Patient AUDIT-C Cutoff Group
1. Alcohol Frequency (Q1) 2: 2-4x/mo
2. Typical Drinks / Day (Q2) 2: 5-6 drinks
3. 6+ Drinks Occasions (Q3) 2: Monthly
4. DAST-10 Substance Screen 1-2/10 (Low)
Step 1 of 3 · Adjust screening items or pick a Quick Case above.
Patient Change Readiness Ruler (1 to 10)
Fine-tune exact ruler score reported by patient
5 / 10
  • 1. Feedback:
  • 2. Listen:
  • 3. Options:
AUDIT-C 6/12 · DAST-10 1-2/10 · Ready 5/10 Hazardous / Moderate Risk
Billing: CPT 99408 / G0396 / H0050 (15-30m) + Mod 25
EMR SOAP & Time Attestation Note 

        


        

          
          

            
            
          

        

        

      

    

  






  

    
Tabular Screening Threshold Triage Matrix

    
Primary care and emergency teams triage alcohol and non-medical substance exposure into four actionable severity tiers. Pair elevated screens with Readiness Ruler scaling before initiating pharmacotherapy or warm handoff.

    

      

        
          

            Instrument
            Low Risk
            Hazardous / Moderate
            High Risk / Likely SUD
            Required Clinician Action & Coding
          

        
        
          

            AUDIT-C (3 items, 0-12)
            0-2 F / 0-3 M
            3-7 F / 4-7 M
            8-12
            FLO Brief Negotiated Interview (5-15 min); CPT 99408 / G0396 at 15+ min; evaluate AUD meds at >=8.
          

          

            Full AUDIT-10 (0-40)
            0-7
            8-15
            16-40 (Zone III-IV)
            Score >=20 warrants diagnostic AUD workup, withdrawal screening (CIWA-Ar), and warm handoff (CPT 99409).
          

          

            DAST-10 (0-10)
            0
            1-5
            6-10
            Check PDMP, offer intranasal naloxone for opioid/polysubstance risk, initiate same-day behavioral handoff (H0050).
          

          

            CRAFFT 2.1+N (Age 12-21)
            0-1
            2+ (No Car Risk)
            2+ with Car / Blackout
            Confidential adolescent brief intervention, safety planning for impaired driving, caregiver engagement when safe.
          

          

            PHQ-4 (Co-Occurring)
            0-2
            3-8
            9-12
            Screen for suicide risk if depressed; co-occurring distress raises SBIRT drop-off without immediate warm handoff.
          

        
      

    


    
Warm-Handoff Clinical Pathway

    
Static referral slips lose up to two-thirds of patients before intake. Introducing an integrated behavioral health clinician inside the exam room during the medical visit converts positive screens into same-day engagement.

    


  Primary Care SBIRT to Warm-Handoff Clinical Pathway
  
  Primary Care & ED SBIRT Warm-Handoff Pathway (Target Elapsed Time: 10 to 20 Minutes)

  
  STEP 1 · ROOMING
  Universal Pre-Screen
  NIAAA single-item alcohol
  NIDA quick drug screen
  Negative: affirm & log
  MA / RN · 60 sec

  
  

  
  STEP 2 · TRIAGE
  Validated Instrument
  AUDIT-C (>=3 F / >=4 M)
  DAST-10 (>=3 moderate+)
  Readiness Ruler (1-10)
  Clinician · 3 min

  
  

  
  STEP 3 · INTERVENTION
  Brief Negotiated FLO
  Feedback on labs/vitals
  Listen to ambivalence
  Options + CPT 99408
  Clinician · 5 to 15 min

  
  

  
  STEP 4 · HANDOFF
  Warm Handoff
  Live intro in exam
  room to PCBH peer
  MAT / SUD linkage
  >80% Same-Day

    


    

      

        
Teaching Clinic & ED Precepting Workflow

        
Clinical teams achieve sustainable SBIRT delivery when nursing or medical assistants complete the 60-second universal pre-screen at rooming, clinicians apply the 5-minute FLO interview during the visit, and behavioral health specialists stand by for warm handoffs.

        
Historically, statewide Wisconsin primary care clinics documented over 110,000 screens and 25,000 brief interventions, demonstrating measurable reductions in binge drinking, trauma crashes, and acute utilization.

        
Open SBIRT Protocol Handbook · View Warm-Handoff Checklist

      

      

        Attending physician and resident physician reviewing a color-coded SBIRT pocket triage card beside an exam room diagnostic panel
        
Pre-visit bedside review of validated AUDIT-C and DAST-10 cutoff thresholds prior to a behavioral health warm handoff.

      

    


    

      
Pocket Triage Summary

      
Adult primary care and ED SBIRT pairs annual universal pre-screening with AUDIT-C and DAST-10 scoring. Scores of 3 or higher for women and older adults, or 4 or higher for adult men, trigger a 5-to-15 minute FLO Brief Negotiated Interview billed under CPT 99408 or G0396, while scores of 8 or higher or DAST-10 scores of 3 or higher initiate a same-day warm handoff.

    


    

      Pocket Reference Note: Standard Drink Equivalents & Clinical Disclaimer
      

        
One U.S. standard drink contains 14 grams of pure ethanol: 12 fl oz regular beer (5% ABV), 5 fl oz table wine (12% ABV), or 1.5 fl oz 80-proof distilled spirits (40% ABV). All client-side calculations execute locally with zero data transmission. Independent educational handbook; see historical provenance disclosure.

      

    


    
Core Clinical Handbook Modules

    

      
      

        Reimbursement · CPT/HCPCS
        
SBIRT Coding, Billing & ROI Manual

        
Time-based rules for CPT 99408/99409, Medicare G0396/G0397, Medicaid H0049/H0050, and Modifier 25 pairing.

      

      

        Integration · PCBH
        
Warm-Handoff Integration Playbook

        
4-stage exam room transfer protocol, script templates, and clinic readiness audit for same-day behavioral support.

      

      

        Safety · Trauma & Perinatal
        
Trauma-Informed & Perinatal SBIRT

        
SAMHSA six trauma-informed principles, 4P's Plus prenatal screening, and person-first charting swaps.

      

    


    
Frequently Asked Clinical Questions

    

      
What AUDIT-C threshold triggers a positive alcohol screen in adult primary care?

      
An AUDIT-C score of 3 or higher for women and adults aged 65 or older, or 4 or higher for adult men under 65, indicates hazardous drinking or active alcohol use disorder and warrants a brief intervention.

    

    

      
When should a resident physician initiate a warm handoff instead of brief advice alone?

      
Initiate a same-day warm handoff to integrated behavioral health whenever AUDIT-C is 8 or higher, DAST-10 is 3 or higher, co-occurring depression or trauma symptoms are present, or the patient expresses readiness for structured change support.