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March 25, 2023

Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse | HCPCS Code G0442

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The  US Preventive Services Task Force (USPSTF) recommends screening for alcohol misuse and behavioral interventions for individuals whose screening results are positive.

Medicare pays for an annual screening for alcohol misuse for all Medicare beneficiaries using HCPCS code G0442.

For those who screen positive, Medicare also pays for a brief face-to-face behavioral counseling session, HCPCS code G0443.

The first of these codes, the screening, has a time range of 5—15 minutes. The second is 15 minutes, so in order to bill them, the record must show that the service took over half of the threshold time, or 7.5 minutes.

G0442 annual alcohol misuse screening, 5—15 minutes

G0443 Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes

All Medicare patients are eligible for screening, and patients who have a positive screen for alcohol misuse are eligible for counseling. Screening is covered annually, and counseling for those who screen positive, is covered four times/year.

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Last revised March 7, 2023 - Betsy Nicoletti
Tags: primary care_preventive services, screening and counseling for behavioral conditions

CPT®️️ is a registered trademark of the American Medical Association. Copyright American Medical Association. All rights reserved.

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Effective January 1, 2023, the AMA has revised the definitions and guidelines for hospital and other E/M services, including ED visits, nursing facility services, home services, and domiciliary care codes. Also, coding for prolonged care services gets another overhaul with revised codes and guidelines. Watch this webinar about all these changes.

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Our mission is to provide up-to-date, simplified, citation driven resources that empower our members to gain confidence and authority in their coding role.

In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. She has been a self-employed consultant since 1998. She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. She has had 2,500 meetings with clinical providers and reviewed over 43,000 medical notes. She knows what questions need answers and developed this resource to answer those questions. For more about Betsy visit www.betsynicoletti.com.

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