Office-Based Opioid Use Disorder (OUD) Treatment Billing

The CMS included new coding and payment for a monthly bundle of services for the treatment of (Opioid Use Disorder) OUD that includes,

• Overall management
• Care coordination
• Individual and group psychotherapy
• Substance use counseling
• Add-on code for additional counseling

The provider to bill for a group of services in the office setting similar to the services covered under the Opioid Treatment Program benefit for clinics.  

Clinicians providing these bundled services to Medicare patients should use these codes,

G2086 - In the first calendar month,

• Developed the treatment plan
• Coordinated care
• Provided at least 70 minutes of individual therapy and group therapy and counseling

G2087 - In a subsequent calendar month,

• Coordinated care
• Provided at least 60 minutes of individual therapy and group therapy and counseling

G2088 -  In a subsequent calendar month,

• Coordinated care
• Provided more than 120 minutes of therapy and counseling
• Note: Bill each additional 30 minutes separately and include the code for the primary procedure
• CPT G2088 add-on code to be reported with CPT G2087

Tips

• G2086 to report the development of a  treatment plan, care coordination, and counseling of at least 70 minutes in the first calendar month

• G2087 to report treatment, care coordination, and counseling of at least 60 minutes after the first month, 

• G2088 for each additional 30 minutes beyond the first 120 minutes (list separately in addition to code for primary procedure).