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HCPCS code G0397: Substance intervention, more than 30 minutes2026 Medicare rate & RVUs in Vermont

Structured alcohol or non-tobacco substance-use assessment and intervention lasting more than 30 minutes, with feedback, motivational counseling, and referral planning when indicated.

CMS RVU26DEffective Oct 1, 2026One payment locality2.4K Medicare services in 2024

In Vermont, Medicare pays $66.10 for G0397 in the office and $53.86 when it’s performed in a hospital or facility.

$66.10Office (non-facility)
$53.86Hospital or facility
−2.0%vs the national office rate ($67.47)

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.

We’ll open G0397 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Vermont
  2. What G0397 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 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 Vermont 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. Vermont pays $66.10. The RVUs are the same everywhere; the geographic indexes change the dollars.

G0397 in Vermont vs other payment areas
  1. Vermont · this page$66.10
  2. Los Angeles, CA · California$72.44+$6.34
  3. Washington, DC area · District of Columbia$73.94+$7.84
  4. Miami, FL · Florida$71.93+$5.83
  5. Chicago, IL · Illinois$70.91+$4.81
  6. Manhattan, NY · New York$75.14+$9.04
  7. Alaska · Alaska$89.54+$23.44

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

Every other payment area

G0397 in every other Medicare payment locality
Payment localityOfficeFacility
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

G0397 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.

$63.27

$89.54

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

View every state and territory as a table
G0397 office rate range by state
State / territoryOffice rate rangeLocalities
AK$89.541
AL$63.741
AR$63.271
AZ$66.461
CA$69.21–$80.7629
CO$68.871
CT$70.501
DC$73.941
DE$67.191
FL$67.69–$71.933
GA$65.57–$68.422
GU$69.461
HI$69.461
IA$64.211
ID$64.501
IL$66.90–$70.914
IN$64.681
KS$64.231
KY$64.861
LA$64.87–$66.512
MA$68.84–$73.202
MD$67.97–$73.943
ME$64.85–$66.412
MI$65.88–$68.312
MN$66.451
MO$64.41–$66.433
MS$63.841
MT$67.471
NC$65.171
ND$66.081
NE$64.341
NH$68.071
NJ$71.43–$73.842
NM$66.141
NV$67.101
NY$65.69–$76.365
OH$65.601
OK$64.631
OR$66.69–$69.982
PA$65.56–$69.592
PR$67.671
RI$68.761
SC$65.471
SD$65.921
TN$64.411
TX$65.35–$68.558
UT$65.931
VA$66.41–$73.942
VI$67.671
VT$66.101
WA$68.63–$74.142
WI$64.941
WV$65.631
WY$66.861

See G0397 in every payment locality

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

Office or facility?

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 Vermont 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

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for G0397 in Vermont
ComponentRVULocality factorAdjusted
Physician work1.30× 1.0001.3000
Practice expense0.65× 0.9900.6435
Malpractice0.07× 0.5060.0354
Total RVUs1.9789
Conversion factor× 33.4009

Office rate, Vermont$66.10

Office: (1.3 × 1 + 0.65 × 0.99 + 0.07 × 0.506) × $33.4009 = $66.10

Facility: (1.3 × 1 + 0.28 × 0.99 + 0.07 × 0.506) × $33.4009 = $53.86

Open G0397 in the RVU calculator

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.

Codes related to G0397

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

Codes related to G0397
CodeHow it relatesOffice range, Vermont
Same family
G0396Brief intervention, alcohol or other substance, 15–30 minutesSame structured assessment and intervention service for 15 through 30 minutes.$35.95
Used instead
G0442Alcohol screening, annual 15-minute preventive screenAlcohol misuse screening service, rather than a prolonged assessment and intervention.$18.42
G0443Alcohol counseling, brief behavioral serviceBrief counseling for alcohol misuse, not the longer alcohol or other substance-use service.$33.61
99409Substance-use screening, over 30 minutesRelated screening and brief intervention code used in CPT reporting contexts.No office rate

How G0397 has changed in Vermont

G0397 · Office / nonfacility

$66.10

Effective 2026-10-01

The base rate is $4.57 higher than on 2025-10-01, moving from $61.53 to $66.10 (7.4%).

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

    $61.53changed to$66.10

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.57 changed to 0.65
    • Practice expense GPCI 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $64.51changed to$61.53

    • 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.

  3. March 9, 2024

    RVU24AR

    $63.46changed to$64.51

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $66.53changed to$63.46

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.60 changed to 0.58
    • Practice expense GPCI 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518

  5. January 1, 2023

    RVU23A

    $67.59changed to$66.53

    • 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
    • Practice expense GPCI 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $66.06changed to$67.59

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.53 changed to 0.59

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $67.42changed to$66.06

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.50 changed to 0.53
    • Practice expense GPCI 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $67.07changed to$67.42

    • Conversion factor 36.0391 changed to 36.0896
    • Malpractice RVU 0.09 changed to 0.11
    • Practice expense GPCI 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $68.98changed to$67.07

    • 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.

  10. January 1, 2018

    RVU18AR1

    $70.60changed to$68.98

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.61 changed to 0.56
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $71.15changed to$70.60

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.63 changed to 0.61
    • Practice expense GPCI 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $69.71changed to$71.15

    • 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.

  13. July 1, 2015

    RVU15C

    $69.37changed to$69.71

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $69.96changed to$69.37

    • 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
    • Practice expense GPCI 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$69.96

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$66.10$53.86RVU26D
2026-07-01$66.10$53.86RVU26C
2026-04-01$66.10$53.86RVU26B
2026-01-01$66.10$53.86RVU26A
2025-10-01$61.53$58.64RVU25D
2025-07-01$61.53$58.64RVU25C
2025-04-01$61.53$58.64RVU25B
2025-01-01$61.53$58.64RVU25A
2024-10-01$64.51$61.54RVU24D
2024-07-01$64.51$61.54RVU24C
2024-04-01$64.51$61.54RVU24B
2024-03-09$64.51$61.54RVU24AR
2024-01-01$63.46$60.54RVU24A
2023-10-01$66.53$63.49RVU23D
2023-07-01$66.53$63.49RVU23C
2023-04-01$66.53$63.49RVU23B
2023-01-01$66.53$63.49RVU23A
2022-10-01$67.59$64.47RVU22D
2022-07-01$67.59$64.47RVU22C
2022-04-01$67.59$64.47RVU22B
2022-01-01$67.59$64.47RVU22A
2021-10-01$66.06$62.91RVU21D
2021-07-01$66.06$62.91RVU21C
2021-04-01$66.06$62.91RVU21B
2021-01-01$66.06$62.91RVU21A
2020-10-01$67.42$64.51RVU20D
2020-07-01$67.42$64.51RVU20C
2020-04-01$67.42$64.51RVU20B
2020-01-01$67.42$64.51RVU20A
2019-10-01$67.07$64.88RVU19D
2019-07-01$67.07$64.88RVU19C
2019-04-01$67.07$64.88RVU19B
2019-01-01$67.07$64.88RVU19A
2018-10-01$68.98$66.78RVU18D
2018-07-01$68.98$66.78RVU18C
2018-04-01$68.98$66.78RVU18B
2018-01-01$68.98$66.78RVU18AR1
2017-10-01$70.60$68.43RVU17D
2017-07-01$70.60$68.43RVU17C
2017-04-01$70.60$68.43RVU17B
2017-01-01$70.60$68.43RVU17A
2016-10-01$71.15$68.63RVU16D
2016-07-01$71.15$68.63RVU16C
2016-04-01$71.15$68.63RVU16B
2016-01-01$71.15$68.63RVU16A
2015-10-01$69.71$67.55RVU15D
2015-07-01$69.71$67.55RVU15C
2015-04-01$69.37$67.21RVU15B
2015-01-01$69.37$67.21RVU15A
2014-10-01$69.96$67.44RVU14D
2014-07-01$69.96$67.44RVU14C
2014-04-01$69.96$67.44RVU14B
2014-01-01$69.96$67.44RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price G0397 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

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
RVUs for G0397PPRRVU2026_Oct_nonQPP.csv, line 15,221 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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