HCPCS G0442: Alcohol screeningMedicare rate & RVUs
Report G0442 for an annual, face-to-face alcohol misuse screening of an adult Medicare patient furnished by a qualified primary care practitioner.
Medicare pays $18.70 for G0442 nationally in the office and $8.02 in a hospital or facility. Local office rates run $16.80–$24.67.
Medicare rate · G0442
Alcohol screening
Swap in your local Medicare rate.
- Work RVUs
- 0.18
- Total RVUs
- 0.56
- Global days
- XXX
National rate · 2026
$18.70
Office setting, before claim adjustments.
See every locality for G0442 → · Billed by an NP, PA or therapist? →
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 10 sections
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.
Where G0442 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$16.80 to $24.67
109 of 109 payment localities
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $22.36 | 1 |
| AL | $17.01 | 1 |
| AR | $16.80 | 1 |
| AZ | $18.27 | 1 |
| CA | $19.84–$24.67 | 29 |
| CO | $19.49 | 1 |
| CT | $19.85 | 1 |
| DC | $21.27 | 1 |
| DE | $18.55 | 1 |
| FL | $18.33–$19.72 | 3 |
| GA | $17.43–$18.99 | 2 |
| GU | $20.26 | 1 |
| HI | $20.26 | 1 |
| IA | $17.45 | 1 |
| ID | $17.54 | 1 |
| IL | $17.82–$19.34 | 4 |
| IN | $17.63 | 1 |
| KS | $17.35 | 1 |
| KY | $17.30 | 1 |
| LA | $17.27–$18.02 | 2 |
| MA | $19.39–$21.31 | 2 |
| MD | $18.89–$21.27 | 3 |
| ME | $17.59–$18.47 | 2 |
| MI | $17.67–$18.50 | 2 |
| MN | $18.83 | 1 |
| MO | $16.99–$18.11 | 3 |
| MS | $16.90 | 1 |
| MT | $18.70 | 1 |
| NC | $17.76 | 1 |
| ND | $18.51 | 1 |
| NE | $17.55 | 1 |
| NH | $19.17 | 1 |
| NJ | $20.11–$21.08 | 2 |
| NM | $17.75 | 1 |
| NV | $18.66 | 1 |
| NY | $17.99–$21.71 | 5 |
| OH | $17.63 | 1 |
| OK | $17.31 | 1 |
| OR | $18.56–$20.09 | 2 |
| PA | $17.67–$19.38 | 2 |
| PR | $18.84 | 1 |
| RI | $19.19 | 1 |
| SC | $17.72 | 1 |
| SD | $18.48 | 1 |
| TN | $17.43 | 1 |
| TX | $17.57–$19.40 | 8 |
| UT | $17.93 | 1 |
| VA | $18.40–$21.27 | 2 |
| VI | $18.84 | 1 |
| VT | $18.42 | 1 |
| WA | $19.36–$21.75 | 2 |
| WI | $17.95 | 1 |
| WV | $17.23 | 1 |
| WY | $18.62 | 1 |
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
Swap in your local Medicare rate.
Work 0.18Practice expense 0.37Malpractice 0.01
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
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).
Non-facility (office) rate · national
$18.70
The facility rate would be $8.02 (+$10.68). In a facility, the facility bills its own costs separately.
G0442 compared with similar codes
Compare codes
G0442 vs G0443 vs G0444 vs G0396 vs 99408: national Medicare rates
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How to choose
- G0443Alcohol counseling
- G0442 reports the annual alcohol misuse screening. G0443 reports a separate 15-minute brief counseling session for a patient who screens positive for alcohol misuse without dependence, with up to four sessions covered per year.
- G0444Depression screening
- G0444 is annual depression screening; G0442 screens for alcohol misuse. Select the code for the condition assessed and document each screening performed.
- G0396Brief intervention
- G0396 describes a structured alcohol or other substance assessment with brief intervention lasting 15–30 minutes. G0442 reports the annual preventive alcohol misuse screening, not an assessment with intervention.
- 99408Audit/dast 15-30 min
- 99408 describes alcohol or substance screening with brief intervention lasting 15–30 minutes. G0442 reports Medicare's annual preventive alcohol misuse screening without that brief intervention.
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
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