Opioid Use Disorder Screening and Treatment

Written by Practice Support Team | May 14, 2024 5:12:00 PM

Medicare pays for opioid use disorder (OUD) screenings performed by physicians and non-physician practitioners. If you diagnose your patient with OUD, they also pay for treatment services.

When Can I Screen My Patients for OUD?

During required screening elements of Medicare's Initial Preventive Physical Exam (IPPE) and Annual Wellness Visit (AWV).
During visits in physician's offices and outpatient hospital settings to screen people who may not seek substance use help. In these cases, you can offer Screening, Brief Intervention, & Referral to Treatment (SBIRT) treatment services.

How Do I Bill for These Screenings?

Service	HCPCS Code	Things to Know
IPPE	G0402	You're required to screen for OUD as part of the IPPE
Initial AWV	G0438	You're required to screen for OUD as part of the AWV
Subsequent AWVs	G0439	You're required to screen for OUD as part of subsequent AWVs
SBIRT	G2011	Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., AUDIT, DAST) and brief intervention 5-14 minutes
SBIRT	G0396	Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., AUDIT, DAST) and brief intervention 15-30 minutes
SBIRT	G0397	Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., AUDIT, DAST) and brief intervention greater than 30 minutes

Click here if you want to learn more about treatment options for OUD, E/M visits for medication management, office-based substance use disorder treatment services and opioid treatment programs (OTPs) and Medicare.

Read this to learn more about behavioral health services Medicare pays for, and help improve the health of your patients!

Source: https://www.cms.gov/medicare/payment/fee-schedules/physician-fee-schedule/opioid-use-disorder-screening-treatment

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