Opioid Use Disorder Screening and Treatment: G0402, G0438, G0439, G2011, G0396, G0397

Medicare coverage includes OUD screening when performed by physicians and NPPs.

OUD screening must be performed as part of a Medicare beneficiary’s IPPE and initial and annual AWV.

• Not separately billable.
• Payment is included in IPPE HCPCS code G0402, and AWV codes G0438 (initial) and G0439. (subsequent)

OUD screening may also be performed during office visits and/or in the outpatient hospital setting. These OUD screening instances may result in SBIRT referral treatment. MLN® Booklet: SBIRT Services.

SBIRT screening and treatment are billed using time based HCPCS codes:

• G2011 (5-14 minutes), G0396 (15-30 minutes), or G0397 (greater than 30 minutes)

Additional details on OUD screening and treatment are found here: Opioid Use Disorder Screening & Treatment | CMS

Note: OUD screening is a separate service from Opioid Treatment Program services. For coverage and billing for OTP services visit the OTP page of our website.

Reviewed 3/19/2024