Office-Based Substance Use Disorder (SUD) Treatment Billing

Office-Based Substance Use Disorder (SUD) Treatment Billing

Office-based SUD treatment services are a way for physicians and non-physician practitioners to bill for a group of services in the office setting We cover a monthly bundle of services for the treatment of Opioid Use Disorder (OUD) or other SUDs.

How Do I Bill for Office-Based SUD Treatment Services?

Coding and billing for a monthly bundle of services for the treatment of SUD includes:

  • Overall management
  • Care coordination
  • Individual and group psychotherapy
  • Substance use counseling
  • Add-on code for additional counseling

HCPCS Code for Office-Based SUD Treatment

Description

G2086

In the first calendar month:

  •  Developed the treatment plan
  • Coordinated care
  • Provided at least 70 minutes of office-based treatment for SUD, which could include development of the treatment plan, care coordination, individual therapy, group therapy, and counseling

G2087

In a subsequent calendar month:

  • Coordinated care
  • Provided at least 60 minutes of office-based treatment for SUD, which could include care coordination, individual therapy, group therapy, and counseling

G2088
  • Coordinated care
  • Provided more than 120 minutes of office-based treatment for SUD, which could include care coordination, individual therapy, group therapy, and counseling
    Note: Bill each additional 30 minutes separately and include the code for primary procedure

 

Medications prescribed as part of in-office treatment could include buprenorphine and naltrexone. If your patient has Medicare Part D coverage, these medications may be covered by their plan.

If you’re treating your patient in the office for OUD but feel they may benefit from a more comprehensive treatment, refer them to an OTP.

Page Last Modified:
09/10/2024 06:13 PM
Help with File Formats and Plug-Ins