Alcohol Misuse Screening & Counseling

Telehealth Eigible:

https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?NCDId=347

HCPCS & CPT Codes

G0442 —

Annual alcohol misuse screening, 5 to 15 minutes

G0443 —

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

ICD-10 Codes

Note: Additional ICD-10 codes may apply. Find individual change requests and specific ICD-10-CM service codes we cover on CMS ICD-10. Find your MAC’s website for more information.

Medicare Covers

Screenings for patients with Medicare Part B (including pregnant women). If they screen positive, we cover patients who:

• Misuse alcohol, but whose levels or alcohol consumption patterns don’t meet alcohol dependence criteria

• Are competent and alert during counseling

• Get counseling from a qualified primary care physician or other primary care practitioner in a primary care setting

Frequency

• Annually (G0442 screening).

• If they screen positive for misuse, 4 face-to-face counseling sessions per year (G0443 counseling). Don’t do more than 1 intervention per day.

See FAQ on how to check eligibility.

Patient Pays

No copayment, coinsurance, or deductible