HCPCS code G0442: Alcohol screening, annual 15-minute preventive screen2026 Medicare rate & RVUs in Utah

Report G0442 for an annual, face-to-face alcohol misuse screening of an adult Medicare patient furnished by a qualified primary care practitioner.

CMS RVU26DEffective Oct 1, 2026One payment locality1M Medicare services in 2024

In Utah, Medicare pays $17.93 for G0442 in the office and $7.88 when it’s performed in a hospital or facility.

$17.93Office (non-facility)
$7.88Hospital or facility
−4.1%vs the national office rate ($18.70)

Check a contract rate as a % of Medicare · G0442 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 G0442 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Utah
  2. What G0442 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 G0442 covers

G0442 covers a face-to-face screen for alcohol misuse in an adult Medicare patient, including a pregnant patient, who uses alcohol but does not meet criteria for alcohol dependence. A qualified primary care physician or other qualified primary care practitioner furnishes the service in a primary care setting, such as a family medicine, internal medicine, or geriatrics practice. A validated alcohol screening instrument, such as the AUDIT or AUDIT-C, helps identify risky drinking. Screening may occur during an Annual Wellness Visit, an initial preventive visit, or a separate primary care encounter.

Report G0442 for the annual 15-minute screening service, supported by documentation of the instrument, findings, interpretation, and time spent. If the patient screens positive for alcohol misuse without dependence, brief face-to-face counseling may be reported separately with G0443 when furnished and documented. When screening and an Annual Wellness Visit occur together, document each service distinctly. A significant, separately identifiable problem-oriented E/M service on the same date requires its own documentation and modifier 25 on the E/M code. Medicare waives the Part B deductible and coinsurance for covered alcohol misuse screening.

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 Utah compares for G0442

Across 109 of 109 payment localities, the office rate for G0442 runs from $16.80 in Arkansas to $24.67 in San Benito County, CA. Utah pays $17.93. The RVUs are the same everywhere; the geographic indexes change the dollars.

G0442 in Utah vs other payment areas
  1. Utah · this page$17.93
  2. Los Angeles, CA · California$21.10+$3.17
  3. Washington, DC area · District of Columbia$21.27+$3.34
  4. Miami, FL · Florida$19.72+$1.79
  5. Chicago, IL · Illinois$19.24+$1.31
  6. Manhattan, NY · New York$21.29+$3.36
  7. Alaska · Alaska$22.36+$4.43

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

Every other payment area

G0442 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$17.01$7.66
ArkansasArkansas$16.80$7.62
ArizonaArizona$18.27$7.92
Bakersfield, CACalifornia$19.87$8.16
Chico, CACalifornia$19.84$8.12
El Centro, CACalifornia$19.84$8.13
Fresno, CACalifornia$19.84$8.12
Hanford, CACalifornia$19.84$8.12

G0442 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.

$16.80

$22.36

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

View every state and territory as a table
G0442 office rate range by state
State / territoryOffice rate rangeLocalities
AK$22.361
AL$17.011
AR$16.801
AZ$18.271
CA$19.84–$24.6729
CO$19.491
CT$19.851
DC$21.271
DE$18.551
FL$18.33–$19.723
GA$17.43–$18.992
GU$20.261
HI$20.261
IA$17.451
ID$17.541
IL$17.82–$19.344
IN$17.631
KS$17.351
KY$17.301
LA$17.27–$18.022
MA$19.39–$21.312
MD$18.89–$21.273
ME$17.59–$18.472
MI$17.67–$18.502
MN$18.831
MO$16.99–$18.113
MS$16.901
MT$18.701
NC$17.761
ND$18.511
NE$17.551
NH$19.171
NJ$20.11–$21.082
NM$17.751
NV$18.661
NY$17.99–$21.715
OH$17.631
OK$17.311
OR$18.56–$20.092
PA$17.67–$19.382
PR$18.841
RI$19.191
SC$17.721
SD$18.481
TN$17.431
TX$17.57–$19.408
UT$17.931
VA$18.40–$21.272
VI$18.841
VT$18.421
WA$19.36–$21.752
WI$17.951
WV$17.231
WY$18.621

See G0442 in every payment locality

How the G0442 rate is calculated

Each of G0442’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 · G0442

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.18

0.18 RVUs× 1.000 GPCI

Practice expense0.37

0.37 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

0.5600

Conversion factor

$33.4009

Medicare rate

$18.70

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

The exact Utah inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

15,262

Code
G0442
Physician work
0.18
Practice expense
0.37
Malpractice
0.01

GPCI2026.csv

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Office calculation for G0442 in Utah
ComponentRVULocality factorAdjusted
Physician work0.18× 1.0000.1800
Practice expense0.37× 0.9400.3478
Malpractice0.01× 0.8980.0090
Total RVUs0.5368
Conversion factor× 33.4009

Office rate, Utah$17.93

Office: (0.18 × 1 + 0.37 × 0.94 + 0.01 × 0.898) × $33.4009 = $17.93

Facility: (0.18 × 1 + 0.05 × 0.94 + 0.01 × 0.898) × $33.4009 = $7.88

Open G0442 in the RVU calculator

Payment rules and modifiers for G0442

G0442 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 · G0442

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$18.70

Non-facility (office)
$18.70
Facility
$8.02

Higher because the practice carries its own overhead.

How G0442 has changed in Utah

G0442 · Office / nonfacility

$17.93

Effective 2026-10-01

The base rate is $1.55 higher than on 2025-10-01, moving from $16.38 to $17.93 (9.5%).

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

    $16.38changed to$17.93

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.34 changed to 0.37
    • Practice expense GPCI 0.933 changed to 0.940
    • Malpractice GPCI 0.930 changed to 0.898

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $18.10changed to$16.38

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.38 changed to 0.34

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $17.81changed to$18.10

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $17.69changed to$17.81

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.36 changed to 0.38
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.865 changed to 0.930
  5. January 1, 2023

    RVU23A

    $17.95changed to$17.69

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense GPCI 0.919 changed to 0.926
    • Malpractice GPCI 0.799 changed to 0.865

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $17.78changed to$17.95

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.35 changed to 0.36

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $17.51changed to$17.78

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.32 changed to 0.35
    • Practice expense GPCI 0.923 changed to 0.919
    • Malpractice GPCI 0.982 changed to 0.799

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $17.60changed to$17.51

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense GPCI 0.927 changed to 0.923
    • Malpractice GPCI 1.165 changed to 0.982

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $17.91changed to$17.60

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.33 changed to 0.32

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $17.50changed to$17.91

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.32 changed to 0.33
    • Practice expense GPCI 0.925 changed to 0.927
    • Malpractice GPCI 1.167 changed to 1.165

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $17.43changed to$17.50

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.922 changed to 0.925
    • Malpractice GPCI 1.169 changed to 1.167

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $17.49changed to$17.43

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $17.40changed to$17.49

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $17.06changed to$17.40

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.31 changed to 0.32
    • Practice expense GPCI 0.919 changed to 0.922
    • Malpractice GPCI 1.136 changed to 1.169

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $17.41changed to$17.06

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.35 changed to 0.31
    • Practice expense GPCI 0.916 changed to 0.919
    • Malpractice GPCI 1.102 changed to 1.136

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $17.41

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$17.93$7.88RVU26D
2026-07-01$17.93$7.88RVU26C
2026-04-01$17.93$7.88RVU26B
2026-01-01$17.93$7.88RVU26A
2025-10-01$16.38$8.54RVU25D
2025-07-01$16.38$8.54RVU25C
2025-04-01$16.38$8.54RVU25B
2025-01-01$16.38$8.54RVU25A
2024-10-01$18.10$8.79RVU24D
2024-07-01$18.10$8.79RVU24C
2024-04-01$18.10$8.79RVU24B
2024-03-09$18.10$8.79RVU24AR
2024-01-01$17.81$8.64RVU24A
2023-10-01$17.69$8.90RVU23D
2023-07-01$17.69$8.90RVU23C
2023-04-01$17.69$8.90RVU23B
2023-01-01$17.69$8.90RVU23A
2022-10-01$17.95$9.05RVU22D
2022-07-01$17.95$9.05RVU22C
2022-04-01$17.95$9.05RVU22B
2022-01-01$17.95$9.05RVU22A
2021-10-01$17.78$9.12RVU21D
2021-07-01$17.78$9.12RVU21C
2021-04-01$17.78$9.12RVU21B
2021-01-01$17.78$9.12RVU21A
2020-10-01$17.51$9.52RVU20D
2020-07-01$17.51$9.52RVU20C
2020-04-01$17.51$9.52RVU20B
2020-01-01$17.51$9.52RVU20A
2019-10-01$17.60$9.58RVU19D
2019-07-01$17.60$9.58RVU19C
2019-04-01$17.60$9.58RVU19B
2019-01-01$17.60$9.58RVU19A
2018-10-01$17.91$9.57RVU18D
2018-07-01$17.91$9.57RVU18C
2018-04-01$17.91$9.57RVU18B
2018-01-01$17.91$9.57RVU18AR1
2017-10-01$17.50$9.53RVU17D
2017-07-01$17.50$9.53RVU17C
2017-04-01$17.50$9.53RVU17B
2017-01-01$17.50$9.53RVU17A
2016-10-01$17.43$9.50RVU16D
2016-07-01$17.43$9.50RVU16C
2016-04-01$17.43$9.50RVU16B
2016-01-01$17.43$9.50RVU16A
2015-10-01$17.49$9.54RVU15D
2015-07-01$17.49$9.54RVU15C
2015-04-01$17.40$9.49RVU15B
2015-01-01$17.40$9.49RVU15A
2014-10-01$17.06$9.49RVU14D
2014-07-01$17.06$9.49RVU14C
2014-04-01$17.06$9.49RVU14B
2014-01-01$17.06$9.49RVU14A
2013-10-01$17.41$8.99RVU13D
2013-07-01$17.41$8.99RVU13C
2013-04-01$17.41$8.99RVU13B
2013-01-01$17.41$8.99RVU13AR

Price G0442 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

G0442 billing questions

How often can G0442 be billed for a Medicare patient?

Medicare covers the alcohol misuse screening annually. Check the patient's screening history before reporting another service, including screening furnished by a different practice.

Can G0442 be billed on the same day as an Annual Wellness Visit?

Yes, when the alcohol misuse screening is separately performed and documented in addition to the wellness visit.

What happens when the screen is positive?

A patient who misuses alcohol but does not meet criteria for dependence may receive brief face-to-face counseling reported with G0443, up to four sessions per year. Refer a patient who appears alcohol dependent for further evaluation and treatment.

Is a modifier needed when billing with a problem-oriented E/M visit?

Append modifier 25 to the E/M code only when a significant, separately identifiable problem-oriented visit is documented on the same date. Do not count the separately reported screening time toward time-based E/M selection.

Can G0442 be billed for screening in an emergency department or inpatient hospital?

Medicare covers G0442 when the screening is furnished by a qualified primary care practitioner in a primary care setting, rather than during an emergency department or inpatient hospital encounter.

What documentation supports G0442?

Record the alcohol screening instrument, the patient's responses or score, the interpretation, and the time spent. A note stating only that alcohol use was discussed does not establish that the screening was performed.

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 G0442PPRRVU2026_Oct_nonQPP.csv, line 15,262 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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