PHQ-A Scoring Guide — Adolescent Depression Screener

The PHQ-A is a 9-item validated depression screening tool adapted from the PHQ-9 for adolescents ages 11–17. Score 0–27; ≥10 indicates moderate depression. Item 9 screens for suicidal ideation. Public domain. Johnson et al. (2002).

What is the PHQ-A?

The PHQ-A (Patient Health Questionnaire, Adolescent) is a validated 9-item self-report depression screening tool adapted from the PHQ-9 for use with adolescents ages 11–17. It was developed by Johnson, Harris, Spitzer, and Williams (2002) and further validated in primary care settings by Richardson et al. (2010). The PHQ-A uses the same nine DSM-IV/5 criterion symptoms as the adult PHQ-9 with age-appropriate language and an additional question about functional impairment.

Each of the 9 items asks how often the adolescent has been bothered by a symptom over the past 2 weeks, rated from 0 (Not at all) to 3 (Nearly every day). Total scores range from 0 to 27. A score of 10 or higher indicates moderate depression and warrants further clinical evaluation. Item 9 asks specifically about thoughts of self-harm or suicide, any positive response (score ≥1) requires immediate clinical attention regardless of total score.

The PHQ-A is in the public domain and freely available for clinical, educational, and research use. It is recommended by the American Academy of Pediatrics (AAP) for annual depression screening in adolescents age 12 and older and is included in USPSTF guidance for adolescent depression screening.

Rate how often you have been bothered by each problem over the past 2 weeks.

Item 9 flagged: Any endorsement of thoughts of self-harm or suicide requires immediate clinical evaluation, regardless of total score. Please consult a mental health professional or call 988 (Suicide & Crisis Lifeline).

Educational reference only. Cannot diagnose or replace clinical evaluation. Any suicidal ideation requires immediate clinical attention.

PHQ-A Score Interpretation

Johnson et al. (2002); Richardson et al. (2010). Endorsed by AAP for annual screening ages 12+. Item 9 (suicidal ideation) always requires clinical review regardless of total score.

Item 9, Suicidal Ideation

Any positive response to Item 9 ("Thoughts that you would be better off dead or of hurting yourself in some way") requires immediate clinical evaluation, regardless of total score. Follow your organization's suicide risk protocol.

Billing the PHQ-A (CPT 96127)

PHQ-A administration qualifies for reimbursement under CPT code 96127 (brief emotional/behavioural assessment). The AMA allows up to 4 units per encounter; Medicare limits this to 3 units per encounter. Each unit = one validated scale administered, scored, and documented. When co-administered with SCARED or CRAFFT in the same encounter, each scale bills as a separate 96127 unit.

Adolescent Mental Health Screening in HiBoop

PHQ-A alongside CRAFFT, Vanderbilt ADHD, and SCARED, automated scoring, suicidal ideation flagging, and longitudinal outcome tracking for your adolescent patient panel.