HCPCS G0443: Alcohol counselingMedicare rate & RVUs in Illinois
G0443 reports a brief, face-to-face counseling service for a patient identified through alcohol misuse screening as needing behavioral guidance.
Medicare pays $34.02–$36.34 for G0443 in the office in Illinois, from Rest Of Illinois to Chicago. Which amount applies depends on the service address.
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 9 sections
What G0443 covers
G0443 captures a brief, face-to-face counseling encounter focused on alcohol misuse, generally provided in primary care after a patient screens positive. The clinician discusses the patient’s alcohol use and offers behavioral guidance aimed at reducing risky consumption. This is counseling, not the screening questionnaire or screening conversation alone, and the service is timed for 15 minutes.
Choose G0443 when the documented service is the counseling intervention; use G0442 for the annual alcohol misuse screen itself. Record the screening result, counseling topics and recommendations, and the time spent in the face-to-face service. CMS assigns physician-work, practice-expense, and malpractice relative values, with separate office and facility practice-expense inputs. The claim should reflect counseling actually furnished rather than screening alone.
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 G0443 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$34.02 to $36.34
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $36.34 | $28.28 |
| East St. Louis | $34.72 | $27.34 |
| Rest Of Illinois | $34.02 | $26.70 |
| Suburban Chicago | $35.93 | $27.69 |
How the G0443 rate is calculated
Each of G0443’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 · G0443
RVUs × geographic indexes × conversion factor
Work0.60
0.60 RVUs× 1.000 GPCI
Practice expense0.39
0.39 RVUs× 1.000 GPCI
Malpractice0.04
0.04 RVUs× 1.000 GPCI
Adjusted RVUs
1.0300
Conversion factor
$33.4009
Medicare rate
$34.40
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for G0443
G0443 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 · G0443
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$34.40
- Non-facility (office)
- $34.40
- Facility
- $26.39
Higher because the practice carries its own overhead.
G0443 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- G0442Alcohol screening
- G0442 is the annual alcohol misuse screening; G0443 is counseling after a positive screen when a counseling intervention is provided.
- 99408Audit/dast 15-30 min
- 99408 describes structured screening and brief intervention under billing code time-based criteria. G0443 is the Medicare HCPCS code for brief alcohol misuse counseling.
- 99409Audit/dast over 30 min
- 99409 is the longer-time billing code screening and brief intervention service. G0443 represents the brief Medicare alcohol counseling service.
G0443 billing questions
How is G0443 different from G0442?
G0442 represents the annual alcohol misuse screening. G0443 represents the subsequent brief counseling service when counseling is furnished.
Can G0442 and G0443 be reported for the same visit?
They may describe separate services in the same encounter when screening and counseling are both performed and documented. Do not use G0443 to represent screening alone.
What documentation supports G0443?
Document the positive screening result, the counseling provided, and the face-to-face time. The note should show an intervention addressing the patient’s alcohol use, not merely a screening result.
What time does G0443 represent?
G0443 is a 15-minute counseling service. Document the time spent in the face-to-face counseling encounter.
How does G0443 differ from billing code 99408 or 99409?
G0443 is the Medicare HCPCS code for brief alcohol misuse counseling. billing code 99408 and 99409 describe structured screening and brief intervention services with different time-based criteria.
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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