May is Mental Health Awareness Month - Substance Use Disorder Benefits

Prior to COVID, Medicare covered medications, Counseling and/or therapy, periodic assessments, and counseling through telehealth, in an office setting, or Outpatient Treatment Program (OTP).

Post-COVID Medicare will cover for patients with opioid use disorders if all other requirements are met:

  • OTP intake add-on code (G2076) to initiate treatment with buprenorphine provided via 2-way, interactive, audio-video or audio-only technology when audio-video technology isn’t available.
  • Periodic patient assessments (HCPCS code G2077) via audio-video technology
  • The therapy and counseling portions of weekly bundles and the add-on code for additional counseling or therapy (HCPCS code G2080) via audio-only technology when audio-video isn’t available.

During the COVID-19 PHE and through the end of CY 2023, Medicare is allowing the following if all other requirements are met:

  • Periodic patient assessments (HCPCS code G2077) via audio-only technology when audio-video technology isn’t available.

Post COVID Modifiers:

  • 95 - counseling and therapy using audio-visual communication
  • FQ - counseling and therapy using audio-only communication

Resources

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