Frequently Asked Questions
Before Getting Started
SEEK helps address risk factors for child abuse and neglect. It does NOT directly mention child abuse and it is NOT a screen for child abuse. Think of SEEK as an approach to help address psychosocial problems facing many families, and thereby:
- Support parents and parenting
- Strengthen families
- Promote children's health, development and safety
- Help prevent child abuse and neglect
Many parents are not used to being questioned about sensitive problems such as substance abuse. The introduction to the SEEK PQ-R / PQ-Re frames the questions positively and helps parents share information they may find embarrassing. The introduction has an empathic tone and normalizes the problems by saying that many families face such difficulties. It’s also stated that completing the PQ-R / PQ-Re is voluntary; naturally some parents may choose not to disclose some information. Nevertheless, asking the questions signals your concern for the family, and the parent may feel comfortable disclosing information at a future time.
Extensive experience has shown that parents rarely mind being asked about sensitive subjects; less than 1% found the questions “too personal” in one SEEK study. For such parents, there may be a learning curve as they understand that their child’s medical professional is also concerned about the family. Many parents, however, are interested in help with psychosocial problems.
In our first SEEK study, parents in the SEEK practices were more satisfied with their child’s healthcare provider compared to controls. In the second SEEK study, we found that parents in both the SEEK and control groups were overwhelmingly positive about their child’s pediatrician or nurse practitioner. We are not aware of parents complaining about SEEK, including repeated completion of the PQ-R / PQ-Re during the multiple checkups for young children.
In the 2nd SEEK study, we compared the average time spent on psychosocial problems during a regular checkup. There was no significant difference between controls and SEEK practices. Having parents complete the SEEK PQ-R / PQ-Re in advance means not having to probe those areas with negative screens during the visit, saving time. This saving is offset, however, when addressing positive screens. A premise of SEEK is that with knowledge and skill, a brief strategic intervention can still make a pivotal difference.
Yes, use CPT codes 96160 or 96161 each time the SEEK PQ-R is completed and responses addressed.
96160 covers the administration of a patient-focused health risk assessment.
96161 covers a parent or caregiver-focused health risk assessment to benefit the patient (i.e., child).
We recommend using CPT Code 96160 as it is more commonly paid by insurers.
Reimbursement varies by state and insurer; please check with your payers.
Guidance for Behavioral Health Professionals
CPT codes 96160 and 96161 describe services a healthcare provider has performed. When billing for these, they require some involvement from a PCP. For practices implementing SEEK, a behavioral health professional or social worker may conduct a brief assessment and make a referral. These services are not billable, but behavioral health professionals working with PCPs can bill indirectly using CPT codes 96160 or 96161.
There is no fee for small practices and resident clinics and for those who engage in the SEEK MOC 4 or Performance Improvement Activity. There may be a fee for practices with more than 10 PCPs or those who are within a healthcare system. Please contact us to see whether or not a fee will apply.
Yes, The Agreement spells out the terms for implementing SEEK, utilizing the copyrighted material, and it enables us to track the adoption of the SEEK approach. One requirement is to provide brief feedback to us every 6 months to help improve the approach.
The SEEK online training requires 3 hours including reading two key articles, at your convenience. There are also recommended supplemental materials. In addition, consider learning about SEEK through our MOC 4 Activity approved by the American Board of Pediatrics and Performance Improvement approved by the American Board of Family Physicians. This is the optimal way to introduce this innovation into your practice, while learning about the Quality Improvement (QI) process. You can also obtain MOC 2 and CME credits for completing the training.
We strongly urge all practitioners to complete the SEEK training before implementing the approach. This is important to improve competency and one’s level of comfort addressing problems that one may not have been trained to address. Those in family medicine, however, may already feel competent and comfortable in this role.
Some practices have access to a social worker or a behavioral health professional. That's ideal but many do not. SEEK offers an approach to implement the approach efficiently in settings without this resource. This does however place more responsibility on the medical professional and office staff. The person who helps with referrals can facilitate a referral to a community agency.
It’s ideal if you have a social worker or behavioral health professional to help identify resources for the targeted problems; if not, office staff can help. findhelp (formerly Aunt Bertha) is a valuable tool for finding local resources. Phone calls are recommended to ensure information is current. The SEEK Parent Handouts list national resources that can often identify local ones. The United Way's 211 number is also valuable for identifying resources in many areas. This information needs periodic updating.
While it’s ideal if all participate, it’s not essential. If some clinicians choose not to participate, the SEEK PQ-R should not be given to their families. Non-participation creates a logistical challenge, but should not affect those participating.
There have been periodic revisions of the SEEK PQ, based on experience from those implementing SEEK, new knowledge, and guidance from experts.
We made several changes in 2023 - the PQ-Re (expanded):
- We added several problems that practitioners regularly asked about.
- We simplified and rephrased some of the wording.
- We now encourage practices to prioritize the problems they choose to address.
- We improved the format.
We hope you approve of these changes and adopt the SEEK PQ-Re. It's currently available in English and Spanish.
We recognize the importance of being practical and prioritizing problems to address. Ideally, this choice should be based on information on the prevalence of problems in your patients' families. It is generally difficult, however, to know this without a needs assessment. Using the PQ-Re for a period (e.g., 3 months), you can learn from parents' responses. The availability of community resources and your ability to offer help for a problem is another consideration.
Although the research was done regarding children 0 - 5, the targeted problems are relevant to families with children of all ages. Teens may be physically punished, and, they may attempt suicide. Thus, addressing discipline may be needed as well as having the poison control number. We encourage those using the screener regarding older children to evaluate its use. Please contact us for help.
We recommend that parents complete only one PQ-R / PQ-Re when bringing in more than one child in for a well-child visit. The introduction asks the parent to respond positively if a question pertains to any of their children. After the assessment, we suggest adding the name of the child(ren) with that issue. The form or information can then be inserted to each child’s medical record.
Review the SEEK Mini Manual. It has all the information you need to implement SEEK.