The alcohol screen came from a six-country WHO project, and Medicare lets the clinician choose the tool
The AUDIT's ten items were chosen from a 150-item schedule given to 1,888 primary care attenders in six countries. Medicare has covered annual alcohol screening since 2011 and, in its own words, does not identify specific screening tools.
We have not finished checking this source. No judgement either way. how we score evidence
Caveat on this rating: The AUDIT-C founding validation excluded women; the WHO project spanned six countries with different drinking cultures. The fee-schedule value of the screen was not read and is not stated.
Significant findings
The Alcohol Use Disorders Identification Test was "developed from a six-country WHO collaborative project as a screening instrument for hazardous and harmful alcohol consumption." Its ten questions "were selected from a 150-item assessment schedule (which was administered to 1888 persons attending representative primary health care facilities)." Each is scored 0 to 4, maximum 40. The three-question AUDIT-C that most US clinics actually use was validated separately in 447 patients at three Veterans Affairs clinics, men only.
Medicare's coverage decision, effective 14 October 2011, covers "annual alcohol screening, and for those that screen positive, up to 4, brief, face-to-face behavioral counseling interventions annually." The decision then says something the depression measure does not: "CMS does not identify specific alcohol misuse screening tools. Rather, the decision to use a specific tool is at the discretion of the clinician in the primary care setting."
Worth asking
Two screens, two rules. For depression, the quality measure names the PHQ-9. For alcohol, Medicare leaves the tool to the clinician. That difference is a choice by the people who write the rules, and it is why one form became a brand and the other did not.
Source
Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption, II — Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M (1993)
Read the source: https://doi.org/10.1111/j.1360-0443.1993.tb02093.x
DOI: 10.1111/j.1360-0443.1993.tb02093.x
How this was scored
- Study design
- not recorded
- Funding
- not recorded
- Published in
- not recorded
- Sample size
- not recorded
- Preregistered
- not recorded
- Conflicts disclosed
- not recorded
- Independent of proponent
- not recorded
- Retracted
- No
We have not finished checking this source, so there is no scoring to show yet. “We have not checked this yet” and “this is disputed” are different statements, so no scored band is shown rather than a low one.
Read the full scoring rubric, including what it can't tell you.
Published September 17, 2026.
Questions
How strong is the evidence behind this?
veisund rates this source "not yet assessed". We have not finished checking this source. No judgement either way. One caveat travels with that badge: The AUDIT-C founding validation excluded women; the WHO project spanned six countries with different drinking cultures. The fee-schedule value of the screen was not read and is not stated. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption, II — Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M (1993). DOI: 10.1111/j.1360-0443.1993.tb02093.x. The full source is linked on this page so you can read it yourself.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.