Reminder for Opioid Treatment Programs: HCPCS G2067 through G2075 Billing Frequency
As of January 1, 2020, the Centers for Medicare & Medicaid Services (CMS) pays Opioid Treatment Programs (OTPs) through bundled payments for opioid use disorder (OUD) treatment services provided to Medicare beneficiaries.
OTP Payment Policy
HCPCS codes G2067 through G2075 represent OTP claim lines for weekly bundled payments. These codes cover episodes of care lasting seven days in a row. OTP providers can’t bill for the same Medicare beneficiary more than once per seven-day period except in certain situations, such as when a patient begins treatment at the OTP in the middle of the OTP’s standard weekly cycle.
See the MLN Opioid Treatment Programs: Medicare Billing and Payment Fact Sheet for more information on billing OTP bundled services.
|
G HCPCS Codes |
Descriptors for OTP Bundled Services |
|---|---|
|
G2067 |
Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a Medicare-enrolled Opioid Treatment Program). |
|
G2068 |
Medication assisted treatment, buprenorphine (oral); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a Medicare-enrolled Opioid Treatment Program). |
|
G2069 |
Medication assisted treatment, buprenorphine (injectable); weekly bundle including dispensing and/ or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a Medicare-enrolled Opioid Treatment Program). |
|
G2070 |
Medication assisted treatment, buprenorphine (implant insertion); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a Medicare-enrolled Opioid Treatment Program). |
|
G2071 |
Medication assisted treatment, buprenorphine (implant removal); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a Medicare-enrolled Opioid Treatment Program). |
|
G2072 |
Medication assisted treatment, buprenorphine (implant insertion and removal); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a Medicare-enrolled Opioid Treatment Program). |
|
G2073 |
Medication assisted treatment, naltrexone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a Medicare-enrolled Opioid Treatment Program). |
|
G2074 |
Medication assisted treatment, weekly bundle not including the drug, including substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a Medicare-enrolled Opioid Treatment Program). |
|
G2075 |
Medication assisted treatment, medication not otherwise specified; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a Medicare-enrolled Opioid Treatment Program); partial episode. |
References
- Opioid Treatment Program Medicare Billing and Payment Fact Sheet
- CMS Opioid Treatment Programs (OTP)