HCPCS code G0397: Substance intervention, more than 30 minutes2026 Medicare rate & RVUs in South Dakota
Structured alcohol or non-tobacco substance-use assessment and intervention lasting more than 30 minutes, with feedback, motivational counseling, and referral planning when indicated.
In South Dakota, Medicare pays $65.92 for G0397 in the office and $53.56 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · G0397 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What G0397 covers
G0397 describes a structured assessment and intervention for alcohol or other substance use, excluding tobacco. The encounter may include reviewing a screening result, discussing health and safety risks, providing motivational feedback and advice about reducing or stopping use, and planning a treatment referral when indicated. It is used for focused clinician-patient encounters in settings such as primary care and outpatient care.
Choose G0397 when the documented time for the structured assessment and intervention exceeds 30 minutes; 15 through 30 minutes is reported with G0396. Document the assessment findings, intervention provided, time spent on this service, the patient’s response, and any referral or follow-up plan. The time should reflect the assessment and intervention rather than unrelated evaluation or routine counseling.
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 South Dakota compares for G0397
Across 109 of 109 payment localities, the office rate for G0397 runs from $63.27 in Arkansas to $89.54 in Alaska. South Dakota pays $65.92. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$65.92
- Los Angeles, CA · California$72.44+$6.52
- Washington, DC area · District of Columbia$73.94+$8.02
- Miami, FL · Florida$71.93+$6.01
- Chicago, IL · Illinois$70.91+$4.99
- Manhattan, NY · New York$75.14+$9.22
- Alaska · Alaska$89.54+$23.62
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $63.74 | $52.93 |
| ArkansasArkansas | $63.27 | $52.66 |
| ArizonaArizona | $66.46 | $54.48 |
| Bakersfield, CACalifornia | $69.46 | $55.92 |
| Chico, CACalifornia | $69.21 | $55.66 |
| El Centro, CACalifornia | $69.22 | $55.67 |
| Fresno, CACalifornia | $69.21 | $55.66 |
| Hanford, CACalifornia | $69.21 | $55.66 |
| Madera, CACalifornia | $69.21 | $55.66 |
| Merced, CACalifornia | $69.21 | $55.66 |
| Modesto, CACalifornia | $69.21 | $55.66 |
| Napa, CACalifornia | $75.96 | $59.67 |
| Oxnard, CACalifornia | $71.76 | $57.15 |
| Redding, CACalifornia | $69.21 | $55.66 |
| Rest of CaliforniaCalifornia | $69.21 | $55.66 |
| Riverside, CACalifornia | $69.99 | $56.45 |
| Sacramento, CACalifornia | $71.49 | $57.11 |
| Salinas, CACalifornia | $71.18 | $56.86 |
| San Diego, CACalifornia | $71.96 | $57.18 |
| Marin County, CACalifornia | $79.23 | $61.81 |
| San Francisco, CACalifornia | $79.15 | $61.73 |
| San Benito County, CACalifornia | $80.76 | $62.94 |
| Santa Clara County, CACalifornia | $80.43 | $62.61 |
| San Luis Obispo, CACalifornia | $70.14 | $56.06 |
| Santa Cruz, CACalifornia | $71.96 | $56.95 |
| Santa Maria, CACalifornia | $71.20 | $56.79 |
| Santa Rosa, CACalifornia | $72.64 | $57.46 |
| Stockton, CACalifornia | $69.21 | $55.66 |
| Vallejo, CACalifornia | $75.84 | $59.56 |
| Visalia, CACalifornia | $69.21 | $55.66 |
| Yuba City, CACalifornia | $69.21 | $55.66 |
| ColoradoColorado | $68.87 | $55.72 |
| ConnecticutConnecticut | $70.50 | $57.19 |
| DelawareDelaware | $67.19 | $54.98 |
| Fort Lauderdale, FLFlorida | $69.64 | $57.12 |
| Rest of FloridaFlorida | $67.69 | $55.88 |
| Atlanta, GAGeorgia | $68.42 | $55.86 |
| Rest of GeorgiaGeorgia | $65.57 | $54.55 |
| Hawaii, Guam, HIHawaii | $69.46 | $55.41 |
| IowaIowa | $64.21 | $52.91 |
| IdahoIdaho | $64.50 | $53.13 |
| East St. Louis, ILIllinois | $68.10 | $56.73 |
| Rest of IllinoisIllinois | $66.90 | $55.61 |
| Suburban Chicago, ILIllinois | $70.16 | $57.47 |
| IndianaIndiana | $64.68 | $53.23 |
| KansasKansas | $64.23 | $53.05 |
| KentuckyKentucky | $64.86 | $53.87 |
| New Orleans, LALouisiana | $66.51 | $54.88 |
| Rest of LouisianaLouisiana | $64.87 | $53.94 |
| Metropolitan Boston, MAMassachusetts | $73.20 | $58.45 |
| Rest of MassachusettsMassachusetts | $68.84 | $55.83 |
| Baltimore area, MDMaryland | $70.30 | $57.04 |
| Rest of MarylandMaryland | $67.97 | $55.47 |
| Rest of MaineMaine | $64.85 | $53.48 |
| Southern Maine, MEMaine | $66.41 | $54.16 |
| Detroit, MIMichigan | $68.31 | $56.39 |
| Rest of MichiganMichigan | $65.88 | $54.60 |
| MinnesotaMinnesota | $66.45 | $53.74 |
| Metropolitan Kansas City, MOMissouri | $66.09 | $54.49 |
| Metropolitan St. Louis, MOMissouri | $66.43 | $54.67 |
| Rest of MissouriMissouri | $64.41 | $53.76 |
| MississippiMississippi | $63.84 | $53.20 |
| MontanaMontana | $67.47 | $55.11 |
| North CarolinaNorth Carolina | $65.17 | $53.64 |
| North DakotaNorth Dakota | $66.08 | $53.72 |
| NebraskaNebraska | $64.34 | $52.94 |
| New HampshireNew Hampshire | $68.07 | $55.20 |
| Northern New JerseyNew Jersey | $73.84 | $59.50 |
| Rest of New JerseyNew Jersey | $71.43 | $57.94 |
| New MexicoNew Mexico | $66.14 | $54.81 |
| NevadaNevada | $67.10 | $54.73 |
| NYC suburbs and Long Island, NYNew York | $76.36 | $61.66 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $71.98 | $58.44 |
| Queens, NYNew York | $75.23 | $60.63 |
| Rest of New YorkNew York | $65.69 | $53.95 |
| OhioOhio | $65.60 | $54.32 |
| OklahomaOklahoma | $64.63 | $53.59 |
| Portland, OROregon | $69.98 | $56.25 |
| Rest of OregonOregon | $66.69 | $54.38 |
| Metropolitan Philadelphia, PAPennsylvania | $69.59 | $56.73 |
| Rest of PennsylvaniaPennsylvania | $65.56 | $54.22 |
| Puerto RicoPuerto Rico | $67.67 | $55.18 |
| Rhode IslandRhode Island | $68.76 | $55.99 |
| South CarolinaSouth Carolina | $65.47 | $54.05 |
| TennesseeTennessee | $64.41 | $53.18 |
| Austin, TXTexas | $68.55 | $55.47 |
| Beaumont, TXTexas | $65.35 | $54.10 |
| Brazoria, TXTexas | $67.11 | $54.86 |
| Dallas, TXTexas | $67.44 | $55.13 |
| Fort Worth, TXTexas | $67.26 | $55.07 |
| Galveston, TXTexas | $67.26 | $54.99 |
| Houston, TXTexas | $68.54 | $56.27 |
| Rest of TexasTexas | $66.14 | $54.41 |
| UtahUtah | $65.93 | $54.31 |
| VirginiaVirginia | $66.41 | $54.27 |
| Virgin Islands, VIUnited States Virgin Islands | $67.67 | $55.18 |
| VermontVermont | $66.10 | $53.86 |
| Rest of WashingtonWashington | $68.63 | $55.61 |
| King County, WAWashington | $74.14 | $58.98 |
| WisconsinWisconsin | $64.94 | $53.10 |
| West VirginiaWest Virginia | $65.63 | $54.89 |
| WyomingWyoming | $66.86 | $54.50 |
G0397 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$63.27
$89.54
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $89.54 | 1 |
| AL | $63.74 | 1 |
| AR | $63.27 | 1 |
| AZ | $66.46 | 1 |
| CA | $69.21–$80.76 | 29 |
| CO | $68.87 | 1 |
| CT | $70.50 | 1 |
| DC | $73.94 | 1 |
| DE | $67.19 | 1 |
| FL | $67.69–$71.93 | 3 |
| GA | $65.57–$68.42 | 2 |
| GU | $69.46 | 1 |
| HI | $69.46 | 1 |
| IA | $64.21 | 1 |
| ID | $64.50 | 1 |
| IL | $66.90–$70.91 | 4 |
| IN | $64.68 | 1 |
| KS | $64.23 | 1 |
| KY | $64.86 | 1 |
| LA | $64.87–$66.51 | 2 |
| MA | $68.84–$73.20 | 2 |
| MD | $67.97–$73.94 | 3 |
| ME | $64.85–$66.41 | 2 |
| MI | $65.88–$68.31 | 2 |
| MN | $66.45 | 1 |
| MO | $64.41–$66.43 | 3 |
| MS | $63.84 | 1 |
| MT | $67.47 | 1 |
| NC | $65.17 | 1 |
| ND | $66.08 | 1 |
| NE | $64.34 | 1 |
| NH | $68.07 | 1 |
| NJ | $71.43–$73.84 | 2 |
| NM | $66.14 | 1 |
| NV | $67.10 | 1 |
| NY | $65.69–$76.36 | 5 |
| OH | $65.60 | 1 |
| OK | $64.63 | 1 |
| OR | $66.69–$69.98 | 2 |
| PA | $65.56–$69.59 | 2 |
| PR | $67.67 | 1 |
| RI | $68.76 | 1 |
| SC | $65.47 | 1 |
| SD | $65.92 | 1 |
| TN | $64.41 | 1 |
| TX | $65.35–$68.55 | 8 |
| UT | $65.93 | 1 |
| VA | $66.41–$73.94 | 2 |
| VI | $67.67 | 1 |
| VT | $66.10 | 1 |
| WA | $68.63–$74.14 | 2 |
| WI | $64.94 | 1 |
| WV | $65.63 | 1 |
| WY | $66.86 | 1 |
How the G0397 rate is calculated
Each of G0397’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 · G0397
RVUs × geographic indexes × conversion factor
Work1.30
1.30 RVUs× 1.000 GPCI
Practice expense0.65
0.65 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
2.0200
Conversion factor
$33.4009
Medicare rate
$67.47
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact South Dakota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
15,221
- Code
- G0397
- Physician work
- 1.30
- Practice expense
- 0.65
- Malpractice
- 0.07
GPCI2026.csv
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.30 | × 1.000 | 1.3000 |
| Practice expense | 0.65 | × 1.000 | 0.6500 |
| Malpractice | 0.07 | × 0.336 | 0.0235 |
| Total RVUs | 1.9735 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$65.92
Office: (1.3 × 1 + 0.65 × 1 + 0.07 × 0.336) × $33.4009 = $65.92
Facility: (1.3 × 1 + 0.28 × 1 + 0.07 × 0.336) × $33.4009 = $53.56
Payment rules and modifiers for G0397
G0397 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 · G0397
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$67.47
- Non-facility (office)
- $67.47
- Facility
- $55.11
Higher because the practice carries its own overhead.
How G0397 has changed in South Dakota
G0397 · Office / nonfacility
$65.92
Effective 2026-10-01
The base rate is $4.57 higher than on 2025-10-01, moving from $61.35 to $65.92 (7.4%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$61.35changed to$65.92
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.57 changed to 0.65
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$64.11changed to$61.35
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.58 changed to 0.57
- Malpractice RVU 0.12 changed to 0.07
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$63.06changed to$64.11
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$65.87changed to$63.06
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.60 changed to 0.58
- Malpractice GPCI 0.364 changed to 0.382
January 1, 2023
RVU23A
$66.73changed to$65.87
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.59 changed to 0.60
- Malpractice RVU 0.11 changed to 0.12
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$65.19changed to$66.73
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.53 changed to 0.59
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$66.42changed to$65.19
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.50 changed to 0.53
- Malpractice GPCI 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$66.13changed to$66.42
- Conversion factor 36.0391 changed to 36.0896
- Malpractice RVU 0.09 changed to 0.11
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$68.08changed to$66.13
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.56 changed to 0.50
- Malpractice RVU 0.08 changed to 0.09
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$69.68changed to$68.08
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.61 changed to 0.56
- Malpractice GPCI 0.395 changed to 0.389
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$70.25changed to$69.68
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 0.63 changed to 0.61
- Malpractice GPCI 0.400 changed to 0.395
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$68.92changed to$70.25
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 0.59 changed to 0.63
- Malpractice RVU 0.07 changed to 0.08
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$68.58changed to$68.92
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$69.26changed to$68.58
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 0.60 changed to 0.59
- Malpractice RVU 0.08 changed to 0.07
- Malpractice GPCI 0.416 changed to 0.400
Held through RVU15B.
January 1, 2014
RVU14A
$67.52changed to$69.26
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.65 changed to 0.60
- Malpractice GPCI 0.432 changed to 0.416
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $67.52
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $65.92 | $53.56 | RVU26D |
| 2026-07-01 | $65.92 | $53.56 | RVU26C |
| 2026-04-01 | $65.92 | $53.56 | RVU26B |
| 2026-01-01 | $65.92 | $53.56 | RVU26A |
| 2025-10-01 | $61.35 | $58.44 | RVU25D |
| 2025-07-01 | $61.35 | $58.44 | RVU25C |
| 2025-04-01 | $61.35 | $58.44 | RVU25B |
| 2025-01-01 | $61.35 | $58.44 | RVU25A |
| 2024-10-01 | $64.11 | $61.11 | RVU24D |
| 2024-07-01 | $64.11 | $61.11 | RVU24C |
| 2024-04-01 | $64.11 | $61.11 | RVU24B |
| 2024-03-09 | $64.11 | $61.11 | RVU24AR |
| 2024-01-01 | $63.06 | $60.11 | RVU24A |
| 2023-10-01 | $65.87 | $62.82 | RVU23D |
| 2023-07-01 | $65.87 | $62.82 | RVU23C |
| 2023-04-01 | $65.87 | $62.82 | RVU23B |
| 2023-01-01 | $65.87 | $62.82 | RVU23A |
| 2022-10-01 | $66.73 | $63.61 | RVU22D |
| 2022-07-01 | $66.73 | $63.61 | RVU22C |
| 2022-04-01 | $66.73 | $63.61 | RVU22B |
| 2022-01-01 | $66.73 | $63.61 | RVU22A |
| 2021-10-01 | $65.19 | $62.05 | RVU21D |
| 2021-07-01 | $65.19 | $62.05 | RVU21C |
| 2021-04-01 | $65.19 | $62.05 | RVU21B |
| 2021-01-01 | $65.19 | $62.05 | RVU21A |
| 2020-10-01 | $66.42 | $63.54 | RVU20D |
| 2020-07-01 | $66.42 | $63.54 | RVU20C |
| 2020-04-01 | $66.42 | $63.54 | RVU20B |
| 2020-01-01 | $66.42 | $63.54 | RVU20A |
| 2019-10-01 | $66.13 | $63.97 | RVU19D |
| 2019-07-01 | $66.13 | $63.97 | RVU19C |
| 2019-04-01 | $66.13 | $63.97 | RVU19B |
| 2019-01-01 | $66.13 | $63.97 | RVU19A |
| 2018-10-01 | $68.08 | $65.92 | RVU18D |
| 2018-07-01 | $68.08 | $65.92 | RVU18C |
| 2018-04-01 | $68.08 | $65.92 | RVU18B |
| 2018-01-01 | $68.08 | $65.92 | RVU18AR1 |
| 2017-10-01 | $69.68 | $67.53 | RVU17D |
| 2017-07-01 | $69.68 | $67.53 | RVU17C |
| 2017-04-01 | $69.68 | $67.53 | RVU17B |
| 2017-01-01 | $69.68 | $67.53 | RVU17A |
| 2016-10-01 | $70.25 | $67.74 | RVU16D |
| 2016-07-01 | $70.25 | $67.74 | RVU16C |
| 2016-04-01 | $70.25 | $67.74 | RVU16B |
| 2016-01-01 | $70.25 | $67.74 | RVU16A |
| 2015-10-01 | $68.92 | $66.76 | RVU15D |
| 2015-07-01 | $68.92 | $66.76 | RVU15C |
| 2015-04-01 | $68.58 | $66.43 | RVU15B |
| 2015-01-01 | $68.58 | $66.43 | RVU15A |
| 2014-10-01 | $69.26 | $66.75 | RVU14D |
| 2014-07-01 | $69.26 | $66.75 | RVU14C |
| 2014-04-01 | $69.26 | $66.75 | RVU14B |
| 2014-01-01 | $69.26 | $66.75 | RVU14A |
| 2013-10-01 | $67.52 | $65.14 | RVU13D |
| 2013-07-01 | $67.52 | $65.14 | RVU13C |
| 2013-04-01 | $67.52 | $65.14 | RVU13B |
| 2013-01-01 | $67.52 | $65.14 | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
G0397 billing questions
How does G0397 differ from G0396?
G0397 is for a structured alcohol or non-tobacco substance-use assessment and intervention lasting more than 30 minutes. G0396 is used when the service lasts 15 through 30 minutes.
Does G0397 include tobacco counseling?
No. G0397 covers alcohol or other substance use, excluding tobacco.
Can a screening alone support G0397?
A screening alone does not describe the structured assessment and intervention represented by G0397. Documentation should show the intervention delivered and the time spent on the service.
What time should the record support?
Document the time spent on the structured assessment and intervention, and show that it exceeds 30 minutes. Do not include unrelated evaluation or routine counseling time in that total.
How does G0397 differ from G0443?
G0443 describes brief counseling for alcohol misuse. G0397 represents a longer structured assessment and intervention and can address substances other than alcohol, excluding tobacco.
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
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