$34.54
Both describe structured alcohol or non-tobacco substance-use assessment and intervention. Use G0397 for more than 30 minutes and G0396 for 15 through 30 minutes.
On this page
CMS RVU26D · Effective 2026-10-01
G0397 Substance intervention Medicare reimbursement rates in Alabama
Structured alcohol or non-tobacco substance-use assessment and intervention lasting more than 30 minutes, with feedback, motivational counseling, and referral planning when indicated. Compare G0397 office and facility rates across CMS payment localities in Alabama.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for G0397 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$63.74
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
Facility setting
$52.93
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Behavioral health
About G0397: Alcohol or substance intervention over 30 minutes
Structured alcohol or non-tobacco substance-use assessment and intervention lasting more than 30 minutes, with feedback, motivational counseling, and referral planning when indicated.
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.
Where the value comes from
- Work RVU1.30 · 64%
- Practice expense (office) RVU0.65 · 32%
- Malpractice RVU0.07 · 3%
2.4K
Medicare services in 2024 · #2342 by national volume
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.
G0397 compared with similar codes
Office rates for Alabama, from the same CMS release.
$17.01
G0442 is an alcohol misuse screening service. G0397 describes a longer assessment and intervention, not screening alone.
$32.19
G0443 is brief counseling focused on alcohol misuse. G0397 covers a longer structured intervention and can address other substances besides tobacco.
99409
No office rateAudit/dast over 30 min
99409 is a related CPT code for screening and brief intervention lasting more than 30 minutes. G0397 is the HCPCS code used for this service in Medicare reporting.
Compare G0397 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
$63.74
Facility
$52.93
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for G0397 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
15,221
- Code
- G0397
- Physician work
- 1.30
- Practice expense
- 0.65
- Malpractice
- 0.07
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.30 | × 1.000 | 1.3000 |
| Practice expense | 0.65 | × 0.875 | 0.5687 |
| Malpractice | 0.07 | × 0.566 | 0.0396 |
| Total RVUs | 1.9084 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alabama$63.74
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.3 | 1 |
| Practice expense | 0.65 | 0.875 |
| Malpractice | 0.07 | 0.566 |
(1.3 × 1 + 0.65 × 0.875 + 0.07 × 0.566) × $33.4009 = $63.74
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.3 | 1 |
| Practice expense | 0.28 | 0.875 |
| Malpractice | 0.07 | 0.566 |
(1.3 × 1 + 0.28 × 0.875 + 0.07 × 0.566) × $33.4009 = $52.93
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
15,218G0384,,Lev 5 hosp type b ed visit,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
15,219G0390,,Trauma respons w/hosp criti,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
15,220G0396,,Alcohol/subs interv 15-30mn,A,,0.65,0.40,,0.16,,0.06,1.11,0.87,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,221G0397,,Alcohol/subs interv >30 min,A,,1.30,0.65,,0.28,,0.07,2.02,1.65,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,222G0398,,Home sleep test/type 2 porta,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,223G0398,26,Home sleep test/type 2 porta,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,224G0398,TC,Home sleep test/type 2 porta,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515