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HCPCS code G0396: Brief intervention, alcohol or other substance, 15–30 minutes2026 Medicare rate & RVUs in Kentucky

Reports a structured alcohol or other substance-use assessment with brief intervention when the clinician spends 15–30 minutes on the service.

CMS RVU26DEffective Oct 1, 2026One payment locality63.1K Medicare services in 2024

In Kentucky, Medicare pays $35.42 for G0396 in the office and $28.30 when it’s performed in a hospital or facility.

$35.42Office (non-facility)
$28.30Hospital or facility
−4.5%vs the national office rate ($37.07)

Check a contract rate as a % of Medicare · G0396 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open G0396 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Kentucky
  2. What G0396 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What G0396 covers

G0396 covers a structured assessment for alcohol or other substance use followed by a brief intervention, with 15–30 minutes spent on the service. A clinician may use an instrument such as AUDIT for alcohol or DAST for drug use, discuss the findings, advise behavior change, and arrange treatment referral when indicated. The service involves more than administering a questionnaire; it includes assessment and a responsive intervention.

Select G0396 based on the documented assessment, intervention, and time, not solely on a substance-use diagnosis or screening result. Record the instrument or assessment method, findings, counseling provided, total service time, and any referral or follow-up plan. Use G0397 when the documented service exceeds 30 minutes. CMS assigns work, practice expense, and malpractice relative values to G0396 in the physician fee schedule, with practice-expense values differing by office and facility setting.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Kentucky compares for G0396

Across 109 of 109 payment localities, the office rate for G0396 runs from $34.22 in Arkansas to $47.90 in Alaska. Kentucky pays $35.42. The RVUs are the same everywhere; the geographic indexes change the dollars.

G0396 in Kentucky vs other payment areas
  1. Kentucky · this page$35.42
  2. Los Angeles, CA · California$39.74+$4.32
  3. Washington, DC area · District of Columbia$40.85+$5.43
  4. Miami, FL · Florida$40.69+$5.27
  5. Chicago, IL · Illinois$39.89+$4.47
  6. Manhattan, NY · New York$41.80+$6.38
  7. Alaska · Alaska$47.90+$12.48

Other areas in Kentucky first, then benchmark localities. Bars start at $0.

Every other payment area

G0396 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$34.54$27.52
ArkansasArkansas$34.22$27.33
ArizonaArizona$36.37$28.60
Bakersfield, CACalifornia$37.99$29.20
Chico, CACalifornia$37.80$29.01
El Centro, CACalifornia$37.81$29.02
Fresno, CACalifornia$37.80$29.01
Hanford, CACalifornia$37.80$29.01

G0396 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$34.22

$47.90

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
G0396 office rate range by state
State / territoryOffice rate rangeLocalities
AK$47.901
AL$34.541
AR$34.221
AZ$36.371
CA$37.80–$44.4429
CO$37.751
CT$38.961
DC$40.851
DE$36.821
FL$37.50–$40.693
GA$36.02–$37.762
GU$38.061
HI$38.061
IA$34.731
ID$34.951
IL$37.04–$39.894
IN$35.071
KS$34.801
KY$35.421
LA$35.45–$36.562
MA$37.72–$40.342
MD$37.29–$40.853
ME$35.25–$36.222
MI$36.17–$37.982
MN$36.051
MO$35.18–$36.443
MS$34.691
MT$37.071
NC$35.461
ND$35.881
NE$34.801
NH$37.371
NJ$39.37–$40.722
NM$36.371
NV$36.751
NY$35.81–$42.715
OH$35.931
OK$35.201
OR$36.43–$38.392
PA$35.87–$38.402
PR$37.191
RI$37.711
SC$35.761
SD$35.741
TN$34.931
TX$35.73–$37.918
UT$36.071
VA$36.26–$40.852
VI$37.191
VT$35.951
WA$37.59–$40.832
WI$35.131
WV$36.191
WY$36.551

See G0396 in every payment locality

How the G0396 rate is calculated

Each of G0396’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · G0396

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.65

0.65 RVUs× 1.000 GPCI

Practice expense0.40

0.40 RVUs× 1.000 GPCI

Malpractice0.06

0.06 RVUs× 1.000 GPCI

Adjusted RVUs

1.1100

Conversion factor

$33.4009

Medicare rate

$37.07

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Kentucky inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

15,220

Code
G0396
Physician work
0.65
Practice expense
0.40
Malpractice
0.06

GPCI2026.csv

55

Locality
Kentucky
Physician work
1.000
Practice expense
0.889
Malpractice
0.915
Office calculation for G0396 in Kentucky
ComponentRVULocality factorAdjusted
Physician work0.65× 1.0000.6500
Practice expense0.40× 0.8890.3556
Malpractice0.06× 0.9150.0549
Total RVUs1.0605
Conversion factor× 33.4009

Office rate, Kentucky$35.42

Office: (0.65 × 1 + 0.4 × 0.889 + 0.06 × 0.915) × $33.4009 = $35.42

Facility: (0.65 × 1 + 0.16 × 0.889 + 0.06 × 0.915) × $33.4009 = $28.30

Open G0396 in the RVU calculator

Payment rules and modifiers for G0396

G0396 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · G0396

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$37.07

Non-facility (office)
$37.07
Facility
$29.06

Higher because the practice carries its own overhead.

Codes related to G0396

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to G0396
CodeHow it relatesOffice range, Kentucky
Same family
G0397Substance intervention, more than 30 minutesMedicare counterpart for a structured alcohol or substance-use assessment and intervention exceeding 30 minutes.$64.86
Used instead
99408Alcohol/substance screening, 15–30 minutesCPT code for a comparable 15–30-minute structured alcohol or other substance-use assessment and brief intervention.No office rate
99409Substance-use screening, over 30 minutesCPT code for the comparable assessment and intervention service when it exceeds 30 minutes.No office rate

How G0396 has changed in Kentucky

G0396 · Office / nonfacility

$35.42

Effective 2026-10-01

The base rate is $3.27 higher than on 2025-10-01, moving from $32.15 to $35.42 (10.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $32.15changed to$35.42

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.34 changed to 0.40
    • Malpractice RVU 0.05 changed to 0.06
    • Practice expense GPCI 0.877 changed to 0.889
    • Malpractice GPCI 0.913 changed to 0.915

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $32.79changed to$32.15

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.33 changed to 0.34

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $32.26changed to$32.79

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $33.26changed to$32.26

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.34 changed to 0.33
    • Malpractice RVU 0.04 changed to 0.05
    • Practice expense GPCI 0.873 changed to 0.877
    • Malpractice GPCI 0.870 changed to 0.913

  5. January 1, 2023

    RVU23A

    $34.15changed to$33.26

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice RVU 0.05 changed to 0.04
    • Practice expense GPCI 0.869 changed to 0.873
    • Malpractice GPCI 0.827 changed to 0.870

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $34.43changed to$34.15

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $35.04changed to$34.43

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.32 changed to 0.34
    • Practice expense GPCI 0.874 changed to 0.869
    • Malpractice GPCI 0.823 changed to 0.827

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $34.73changed to$35.04

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.31 changed to 0.32
    • Practice expense GPCI 0.880 changed to 0.874
    • Malpractice GPCI 0.819 changed to 0.823

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $34.69changed to$34.73

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $34.52changed to$34.69

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 0.876 changed to 0.880
    • Malpractice GPCI 0.807 changed to 0.819

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $34.40changed to$34.52

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.32 changed to 0.31
    • Malpractice RVU 0.04 changed to 0.05
    • Practice expense GPCI 0.872 changed to 0.876
    • Malpractice GPCI 0.795 changed to 0.807

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $34.84changed to$34.40

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 0.33 changed to 0.32

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $34.67changed to$34.84

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $35.01changed to$34.67

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.34 changed to 0.33
    • Malpractice GPCI 0.774 changed to 0.795

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $34.40changed to$35.01

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.38 changed to 0.34
    • Practice expense GPCI 0.871 changed to 0.872
    • Malpractice GPCI 0.752 changed to 0.774

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $34.40

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$35.42$28.30RVU26D
2026-07-01$35.42$28.30RVU26C
2026-04-01$35.42$28.30RVU26B
2026-01-01$35.42$28.30RVU26A
2025-10-01$32.15$29.59RVU25D
2025-07-01$32.15$29.59RVU25C
2025-04-01$32.15$29.59RVU25B
2025-01-01$32.15$29.59RVU25A
2024-10-01$32.79$30.16RVU24D
2024-07-01$32.79$30.16RVU24C
2024-04-01$32.79$30.16RVU24B
2024-03-09$32.79$30.16RVU24AR
2024-01-01$32.26$29.67RVU24A
2023-10-01$33.26$30.31RVU23D
2023-07-01$33.26$30.31RVU23C
2023-04-01$33.26$30.31RVU23B
2023-01-01$33.26$30.31RVU23A
2022-10-01$34.15$31.44RVU22D
2022-07-01$34.15$31.44RVU22C
2022-04-01$34.15$31.44RVU22B
2022-01-01$34.15$31.44RVU22A
2021-10-01$34.43$31.70RVU21D
2021-07-01$34.43$31.70RVU21C
2021-04-01$34.43$31.70RVU21B
2021-01-01$34.43$31.70RVU21A
2020-10-01$35.04$32.51RVU20D
2020-07-01$35.04$32.51RVU20C
2020-04-01$35.04$32.51RVU20B
2020-01-01$35.04$32.51RVU20A
2019-10-01$34.73$32.51RVU19D
2019-07-01$34.73$32.51RVU19C
2019-04-01$34.73$32.51RVU19B
2019-01-01$34.73$32.51RVU19A
2018-10-01$34.69$32.79RVU18D
2018-07-01$34.69$32.79RVU18C
2018-04-01$34.69$32.79RVU18B
2018-01-01$34.69$32.79RVU18AR1
2017-10-01$34.52$32.64RVU17D
2017-07-01$34.52$32.64RVU17C
2017-04-01$34.52$32.64RVU17B
2017-01-01$34.52$32.64RVU17A
2016-10-01$34.40$32.53RVU16D
2016-07-01$34.40$32.53RVU16C
2016-04-01$34.40$32.53RVU16B
2016-01-01$34.40$32.53RVU16A
2015-10-01$34.84$32.96RVU15D
2015-07-01$34.84$32.96RVU15C
2015-04-01$34.67$32.80RVU15B
2015-01-01$34.67$32.80RVU15A
2014-10-01$35.01$33.14RVU14D
2014-07-01$35.01$33.14RVU14C
2014-04-01$35.01$33.14RVU14B
2014-01-01$35.01$33.14RVU14A
2013-10-01$34.40$32.32RVU13D
2013-07-01$34.40$32.32RVU13C
2013-04-01$34.40$32.32RVU13B
2013-01-01$34.40$32.32RVU13AR

Price G0396 for an earlier date of service

Where the Kentucky rate applies

Kentucky is a Medicare payment area, not a city. Our Census mapping connects it to 553 cities and communities in Kentucky. Some span more than one payment area; confirm with the service ZIP.

  • Adairville
  • Ages
  • Albany
  • Alexandria
  • Allen
  • Allensville
  • Anchorage
  • Annville

Browse all communities in Kentucky

G0396 billing questions

When should G0396 be used instead of G0397?

Use G0396 for a documented structured assessment and brief intervention lasting 15–30 minutes. G0397 is the longer-duration counterpart for services exceeding 30 minutes.

Does administering a screening questionnaire alone support G0396?

No. G0396 includes a brief intervention after the structured assessment; document the discussion or counseling that followed the assessment.

What documentation should support G0396?

Record the assessment method or instrument, results, intervention provided, total service time, and any referral or follow-up plan.

Can the same counseling time be counted toward an office visit and G0396?

Do not count the same work or time twice. Document the substance-use assessment and intervention distinctly from any separately reported evaluation and management service.

How many units of G0396 are reported for a 15–30-minute service?

G0396 represents the 15–30-minute service. Document the total time supporting that service; use G0397 when the service exceeds 30 minutes.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for G0396PPRRVU2026_Oct_nonQPP.csv, line 15,220 (RVU26D)
Geographic factors for KentuckyGPCI2026.csv, line 55 (RVU26D)

Open CMS sourceHow we calculate rates

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