JJ Part A 2021 Opioid Treatment Program Rates

Published 01/19/2021

Rates are effective January 1, 2021.

Alabama

HCPCS Code
Modifier
Contractor Number
Locality
Fee
G2067
 
10112
00
$202.57
G2068
 
10112
00
$246.27
G2069
 
10112
00
$1,810.29
G2070
 
10112
00
$4,938.37
G2071
 
10112
00
$409.90
G2072
 
10112
00
$5,148.55
G2073
 
10112
00
$1,400.28
G2074
 
10112
00
$155.12
G2075
 
10112
00
$0.00
G2076
 
10112
00
$172.14
G2077
 
10112
00
$105.78
G2078
 
10112
00
$37.38
G2079
 
10112
00
$81.08
G2080
 
10112
00
$29.68
G2215
 
10112
00
$92.02
G2216
 
10112
00
$13.71

Georgia

HCPCS Code
Modifier
Contractor Number
Locality
Fee
G2067
 
10212
01
$211.13
G2068
 
10212
01
$254.83
G2069
 
10212
01
$1,819.16
G2070
 
10212
01
$4,958.63
G2071
 
10212
01
$431.13
G2072
 
10212
01
$5,179.70
G2073
 
10212
01
$1,409.15
G2074
 
10212
01
$163.15
G2075
 
10212
01
$0.00
G2076
 
10212
01
$181.06
G2077
 
10212
01
$111.26
G2078
 
10212
01
$37.38
G2079
 
10212
01
$81.08
G2080
 
10212
01
$31.21
G2215
 
10212
01
$92.15
G2216
 
10212
01
$14.02
G2067
 
10212
99
$201.70
G2068
 
10212
99
$245.40
G2069
 
10212
99
$1,809.38
G2070
 
10212
99
$4,936.30
G2071
 
10212
99
$407.74
G2072
 
10212
99
$5,145.37
G2073
 
10212
99
$1,399.37
G2074
 
10212
99
$154.30
G2075
 
10212
99
$0.00
G2076
 
10212
99
$171.23
G2077
 
10212
99
$105.22
G2078
 
10212
99
$37.38
G2079
 
10212
99
$81.08
G2080
 
10212
99
$29.52
G2215
 
10212
99
$92.01
G2216
 
10212
99
$13.68

Tennessee

HCPCS Code
Modifier
Contractor Number
Locality
Fee
G2067
 
10312
35
$199.78
G2068
 
10312
35
$243.48
G2069
 
10312
35
$1,807.39
G2070
 
10312
35
$4,931.75
G2071
 
10312
35
$402.97
G2072
 
10312
35
$5,138.38
G2073
 
10312
35
$1,397.38
G2074
 
10312
35
$152.49
G2075
 
10312
35
$0.00
G2076
 
10312
35
$169.23
G2077
 
10312
35
$103.99
G2078
 
10312
35
$37.38
G2079
 
10312
35
$81.08
G2080
 
10312
35
$29.17
G2215
 
10312
35
$91.98
G2216
 
10312
35
$13.72