Under the ACA, Women’s Preventative services, what constitutes “screening and counseling for domestic and interpersonal violence”?

Is there a limit to the number of sessions for counseling? Is this only intended as a quick Q & A type session in a visit with a primary care provider? or does it include on-going counseling provided by a mental health counselor related to domestic violence, patterns of family of origin abuse, and relationship patterns (ie how to recognize and avoid abusers, potentially abusive situations?) Is it intended to help deal with the lingering effects of C-PTSD after relationship with someone with Narcissistic Personality Disorder/Sociopathic Personality Disorder?


The Affordable Care Act covers screening and counseling for domestic and interpersonal violence as a free preventive service for women. More details services and frequency of these services was clarified by HHS and CMS in the following years after the law was passed. Aside from what is covered for free even more is required to be covered with cost sharing due to the ACA requiring all plans to cover ten essential benefits (which includes domestic violence related services). Here are the details we have on exactly what is covered.

"Screening may consist of a few, brief, open-ended questions. Screening can be facilitated by the use of brochures, forms, or other assessment tools including chart prompts. One option is the five-question Abuse Assessment Screening tool available here: (http://www.cdc.gov/ncipc/pub-res/images/ipvandsvscreening.pdf, page 22). Counseling provides basic information, including how a patient’s health concerns may relate to violence and referrals to local domestic violence support agencies when patients disclose abuse. Easy-to-use tools such as patient brochures, safety plans, and provider educational tools, as well as training materials, are available through the HHS-funded Domestic Violence Resource Network, including the National Resource Center on Domestic Violence (http://www.acf.hhs.gov/programs/fysb/programs/family-violence-prevention-services/programs/centers)."

This fact sheet from CMS helps clarify a bit.

From what we understand this does not specifically provide ongoing counseling as a free service, but the ten essential benefits should mean that ongoing counseling is covered under all non-grandfathered plans. Although these additional services may be subject to cost sharing.

I know you are looking for more specific details, but we haven't been able to gather them. That being said we hope by posting this Q&A along with the information we do have that people will comment below with a additional information and questions that help us all find a satisfactory answer.

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Rayshawnda Harrison on

This article has been greatfully interesting and helpful