HCPCS G2011: Misuse assessmentMedicare rate & RVUs in Maine
Report G2011 for a 5- to 15-minute structured assessment of alcohol or non-tobacco substance misuse, such as an AUDIT or DAST screening.
Medicare pays $16.56–$16.95 for G2011 in the office in Maine, from Rest Of Maine to Southern Maine. 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 G2011 covers
G2011 covers a structured assessment of possible alcohol or non-tobacco substance misuse, typically performed during an outpatient primary care or behavioral health visit. A clinician may use a validated instrument such as the AUDIT for alcohol use or the DAST for drug use. The service is the assessment itself; it is not a general discussion of substance use or counseling alone. The code describes an assessment lasting 5 to 15 minutes.
Report G2011 when the structured assessment and its time are documented. Record the instrument or assessment method, the time spent, and the findings. A positive result may lead to further evaluation or counseling, but those activities are distinct from the assessment. CMS assigns physician fee schedule resource values to G2011, including practice-expense inputs that differ by office and facility setting; FeeBase displays payment rates separately.
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 G2011 pays more and less in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Maine | $16.56 | $14.10 |
| Southern Maine | $16.95 | $14.30 |
How the G2011 rate is calculated
Each of G2011’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 · G2011
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.33Practice expense 0.16Malpractice 0.03
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for G2011
G2011 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 · G2011
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
Non-facility (office) rate · national
$17.37
The facility rate would be $14.70 (+$2.67). In a facility, the facility bills its own costs separately.
G2011 compared with similar codes
Compare codes
G2011 vs G0442 vs 99408 vs 99409: national Medicare rates
Swap in your local Medicare rate.
How to choose
- G0442Alcohol screening
- G0442 is Medicare alcohol-misuse screening. G2011 covers a structured alcohol or non-tobacco substance assessment lasting 5 to 15 minutes.
- 99408Audit/dast 15-30 min
- 99408 describes screening plus brief intervention for alcohol or substance misuse. G2011 describes a shorter structured assessment, not the intervention.
- 99409Audit/dast over 30 min
- 99409 is for screening and brief intervention at a longer time level. G2011 covers a structured assessment lasting 5 to 15 minutes.
G2011 billing questions
When should G2011 be chosen over G0442?
G2011 describes a 5- to 15-minute structured assessment of alcohol or non-tobacco substance misuse. G0442 is the Medicare alcohol-misuse screening service; it is limited to alcohol screening.
Does G2011 include counseling or treatment?
No. G2011 describes the structured assessment. Counseling or treatment is a distinct service and requires its own documentation and applicable coding.
What should the record show?
Document the assessment method or tool, the time spent, and the result. The record should make clear that the work was a structured assessment rather than an informal discussion.
How much time does G2011 represent?
G2011 is for a structured assessment lasting 5 to 15 minutes. Base the selection on time spent on the assessment, not the total visit length.
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
Fee sheets
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