HCPCS G2086: Opioid treatmentMedicare rate & RVUs
Reports the monthly office-based opioid use disorder treatment package when qualifying treatment activities total at least 70 minutes in the initial calendar month.
Medicare pays $491.33 for G2086 nationally in the office and $362.73 in a hospital or facility. Local office rates run $454.30–$634.09.
Medicare rate · G2086
Opioid treatment
Swap in your local Medicare rate.
- Work RVUs
- 8.36
- Total RVUs
- 14.71
- Global days
- XXX
National rate · 2026
$491.33
Office setting, before claim adjustments.
See every locality for G2086 → · 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 G2086 covers
G2086 represents the monthly office-based treatment package for a patient receiving care for opioid use disorder during the initial calendar month. The work may include treatment planning, coordination with other clinicians or support services, psychotherapy, counseling, and medication-related management. It is used by clinicians providing outpatient OUD care outside an opioid treatment program, such as a physician or other qualified practitioner in an office setting.
Report G2086 when qualifying services total at least 70 minutes during that first calendar month; the time is accumulated across qualifying activities, not counted separately for each visit. Documentation should identify the treatment activities, dates, practitioners involved, and total time supporting the monthly threshold. G2087 is the corresponding base service for a subsequent calendar month, while G2088 may be reported for qualifying additional treatment time beyond the base service.
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 G2086 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
$454.30 to $634.09
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $458.42 | $345.90 |
| Alaska* | $634.09 | $497.13 |
| Arizona | $482.41 | $357.81 |
| Arkansas | $454.30 | $343.84 |
| Atlanta | $499.39 | $368.74 |
| Austin | $500.63 | $364.57 |
| Bakersfield | $506.91 | $365.97 |
| Baltimore/Surr. Cntys | $514.67 | $376.69 |
| Beaumont | $472.63 | $355.61 |
| Brazoria | $487.28 | $359.85 |
| Chicago | $521.06 | $391.82 |
| Chico | $504.84 | $363.90 |
| Colorado | $502.39 | $365.57 |
| Connecticut | $516.00 | $377.50 |
| Dallas | $490.13 | $362.06 |
| Dc + Md/Va Suburbs | $542.81 | $391.33 |
| Delaware | $488.34 | $361.28 |
| Detroit | $498.83 | $374.74 |
| East St. Louis | $497.01 | $378.71 |
| El Centro | $504.94 | $364.00 |
| Fort Lauderdale | $510.55 | $380.28 |
| Fort Worth | $488.49 | $361.70 |
| Fresno | $504.84 | $363.90 |
| Galveston | $488.66 | $360.97 |
| Hanford-Corcoran | $504.84 | $363.90 |
| Hawaii, Guam | $508.83 | $362.62 |
| Houston | $500.01 | $372.31 |
| Idaho | $465.10 | $346.80 |
| Indiana | $466.71 | $347.51 |
| Iowa | $462.57 | $344.91 |
| Kansas | $462.68 | $346.43 |
| Kentucky | $468.32 | $354.00 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $530.84 | $378.72 |
| Madera | $504.84 | $363.90 |
| Manhattan | $552.34 | $402.91 |
| Merced | $504.84 | $363.90 |
| Metropolitan Boston | $537.63 | $384.09 |
| Metropolitan Kansas City | $479.18 | $358.43 |
| Metropolitan Philadelphia | $508.20 | $374.33 |
| Metropolitan St. Louis | $482.18 | $359.76 |
| Miami | $530.84 | $396.97 |
| Minnesota | $482.30 | $349.98 |
| Mississippi | $459.32 | $348.60 |
| Modesto | $504.84 | $363.90 |
| Montana** | $491.29 | $362.69 |
| Napa | $559.59 | $390.11 |
| Nebraska | $463.71 | $345.02 |
| Nevada** | $488.06 | $359.34 |
| New Hampshire | $496.59 | $362.72 |
| New Mexico | $479.60 | $361.68 |
| New Orleans | $482.85 | $361.85 |
| North Carolina | $471.03 | $351.05 |
| North Dakota** | $479.03 | $350.43 |
| Northern Nj | $540.95 | $391.78 |
| Nyc Suburbs/Long Island | $563.12 | $410.22 |
| Ohio | $474.84 | $357.44 |
| Oklahoma | $466.23 | $351.40 |
| Oxnard-Thousand Oaks-Ventura | $526.17 | $374.17 |
| Portland | $511.74 | $368.87 |
| Poughkpsie/N Nyc Suburbs | $526.42 | $385.61 |
| Puerto Rico | $493.12 | $363.11 |
| Queens | $553.18 | $401.19 |
| Redding | $504.84 | $363.90 |
| Rest Of California | $504.84 | $363.90 |
| Rest Of Florida | $493.32 | $370.39 |
| Rest Of Georgia | $474.63 | $359.93 |
| Rest Of Illinois | $486.34 | $368.93 |
| Rest Of Louisiana | $468.45 | $354.64 |
| Rest Of Maine | $468.19 | $349.88 |
| Rest Of Maryland | $494.72 | $364.58 |
| Rest Of Massachusetts | $501.73 | $366.33 |
| Rest Of Michigan | $477.35 | $359.94 |
| Rest Of Missouri | $464.38 | $353.53 |
| Rest Of New Jersey | $522.11 | $381.69 |
| Rest Of New York | $475.61 | $353.44 |
| Rest Of Oregon | $484.41 | $356.33 |
| Rest Of Pennsylvania | $474.49 | $356.45 |
| Rest Of Texas | $479.56 | $357.52 |
| Rest Of Washington | $500.15 | $364.74 |
| Rhode Island | $500.71 | $367.87 |
| Riverside-San Bernardino-Ontario | $511.68 | $370.74 |
| Sacramento-Roseville-Folsom | $522.97 | $373.41 |
| Salinas | $520.81 | $371.77 |
| San Diego-Chula Vista-Carlsbad | $527.73 | $373.93 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $585.12 | $403.80 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $584.42 | $403.10 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $597.03 | $411.60 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $594.15 | $408.72 |
| San Luis Obispo-Paso Robles | $513.07 | $366.60 |
| Santa Cruz-Watsonville | $528.73 | $372.49 |
| Santa Maria-Santa Barbara | $521.31 | $371.37 |
| Santa Rosa-Petaluma | $533.73 | $375.82 |
| Seattle (King Cnty) | $544.94 | $387.16 |
| South Carolina | $473.68 | $354.86 |
| South Dakota** | $477.58 | $348.98 |
| Southern Maine | $481.96 | $354.53 |
| Stockton | $504.84 | $363.90 |
| Suburban Chicago | $514.44 | $382.37 |
| Tennessee | $464.32 | $347.43 |
| Utah | $477.73 | $356.85 |
| Vallejo | $558.58 | $389.09 |
| Vermont | $479.18 | $351.88 |
| Virgin Islands | $493.12 | $363.11 |
| Virginia | $481.99 | $355.58 |
| Visalia | $504.84 | $363.90 |
| West Virginia | $475.18 | $363.43 |
| Wisconsin | $468.96 | $345.77 |
| Wyoming** | $485.94 | $357.35 |
| Yuba City | $504.84 | $363.90 |
G2086 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.
$454.30
$634.09
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 | $634.09 | 1 |
| AL | $458.42 | 1 |
| AR | $454.30 | 1 |
| AZ | $482.41 | 1 |
| CA | $504.84–$597.03 | 29 |
| CO | $502.39 | 1 |
| CT | $516.00 | 1 |
| DC | $542.81 | 1 |
| DE | $488.34 | 1 |
| FL | $493.32–$530.84 | 3 |
| GA | $474.63–$499.39 | 2 |
| GU | $508.83 | 1 |
| HI | $508.83 | 1 |
| IA | $462.57 | 1 |
| ID | $465.10 | 1 |
| IL | $486.34–$521.06 | 4 |
| IN | $466.71 | 1 |
| KS | $462.68 | 1 |
| KY | $468.32 | 1 |
| LA | $468.45–$482.85 | 2 |
| MA | $501.73–$537.63 | 2 |
| MD | $494.72–$542.81 | 3 |
| ME | $468.19–$481.96 | 2 |
| MI | $477.35–$498.83 | 2 |
| MN | $482.30 | 1 |
| MO | $464.38–$482.18 | 3 |
| MS | $459.32 | 1 |
| MT | $491.29 | 1 |
| NC | $471.03 | 1 |
| ND | $479.03 | 1 |
| NE | $463.71 | 1 |
| NH | $496.59 | 1 |
| NJ | $522.11–$540.95 | 2 |
| NM | $479.60 | 1 |
| NV | $488.06 | 1 |
| NY | $475.61–$563.12 | 5 |
| OH | $474.84 | 1 |
| OK | $466.23 | 1 |
| OR | $484.41–$511.74 | 2 |
| PA | $474.49–$508.20 | 2 |
| PR | $493.12 | 1 |
| RI | $500.71 | 1 |
| SC | $473.68 | 1 |
| SD | $477.58 | 1 |
| TN | $464.32 | 1 |
| TX | $472.63–$500.63 | 8 |
| UT | $477.73 | 1 |
| VA | $481.99–$542.81 | 2 |
| VI | $493.12 | 1 |
| VT | $479.18 | 1 |
| WA | $500.15–$544.94 | 2 |
| WI | $468.96 | 1 |
| WV | $475.18 | 1 |
| WY | $485.94 | 1 |
How the G2086 rate is calculated
Each of G2086’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 · G2086
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.36Practice expense 5.73Malpractice 0.62
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for G2086
G2086 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 · G2086
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
Non-facility (office) rate · national
$491.33
The facility rate would be $362.73 (+$128.60). In a facility, the facility bills its own costs separately.
G2086 compared with similar codes
Compare codes
G2086 vs G2087 vs G2088 vs G2068: national Medicare rates
Swap in your local Medicare rate.
How to choose
- G2087Opioid treatment
- Use G2086 for the initial calendar month of office-based OUD treatment; G2087 is for a subsequent month and uses a different minimum-time threshold.
- G2088Opioid treatment
- G2088 reports additional qualifying treatment time beyond a base monthly service; it does not replace G2086 for the initial month.
- G2068Med assist tx bupre oral
- G2068 is an opioid treatment program bundle involving oral buprenorphine treatment. G2086 represents office-based treatment over the initial calendar month.
G2086 billing questions
How does G2086 differ from G2087?
G2086 applies to the initial calendar month of office-based opioid use disorder treatment and requires at least 70 minutes. G2087 is for a subsequent calendar month and has a 60-minute threshold.
Is G2086 reported once for each treatment visit?
No. It represents qualifying treatment activities accumulated during the initial calendar month, rather than a separate code for each visit.
What documentation supports the time threshold?
Record the qualifying treatment activities, service dates, practitioners involved, and the total time for the month. The record should make clear that the services relate to office-based opioid use disorder treatment.
When is G2088 reported with G2086?
G2088 is the add-on code for qualifying additional treatment time beyond the base monthly service. The documentation must support the additional time reported.
Is G2086 the same as an opioid treatment program bundle?
No. G2086 describes a monthly office-based treatment package; opioid treatment program codes such as G2068 describe a different treatment setting and bundle.
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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