HCPCS G0396: Brief interventionMedicare rate & RVUs in Utah
Reports a structured alcohol or other substance-use assessment with brief intervention when the clinician spends 15–30 minutes on the service.
Medicare pays $36.07 for G0396 in the office in Utah (Utah). 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 G0396 covers
G0396 covers a structured assessment for alcohol or other substance use followed by a brief intervention, with 15–30 minutes spent on the service. A clinician may use an instrument such as AUDIT for alcohol or DAST for drug use, discuss the findings, advise behavior change, and arrange treatment referral when indicated. The service involves more than administering a questionnaire; it includes assessment and a responsive intervention.
Select G0396 based on the documented assessment, intervention, and time, not solely on a substance-use diagnosis or screening result. Record the instrument or assessment method, findings, counseling provided, total service time, and any referral or follow-up plan. Use G0397 when the documented service exceeds 30 minutes. CMS assigns work, practice expense, and malpractice relative values to G0396 in the physician fee schedule, with practice-expense values differing by office and facility setting.
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.
G0396 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $36.07 | $28.53 |
How the G0396 rate is calculated
Each of G0396’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 · G0396
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.65Practice expense 0.40Malpractice 0.06
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for G0396
G0396 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 · G0396
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
Non-facility (office) rate · national
$37.07
The facility rate would be $29.06 (+$8.01). In a facility, the facility bills its own costs separately.
G0396 compared with similar codes
Compare codes
G0396 vs G0397 vs G0442 vs G0443 vs 99408: national Medicare rates
Swap in your local Medicare rate.
How to choose
- G0397Substance intervention
- G0397 is the longer-duration Medicare code, used when the structured assessment and intervention exceed 30 minutes; G0396 covers 15–30 minutes.
- G0442Alcohol screening
- G0442 reports alcohol misuse screening. G0396 includes a structured assessment plus a brief intervention and also covers substances other than alcohol.
- G0443Alcohol counseling
- G0443 reports brief counseling for alcohol misuse after a positive screen. G0396 combines structured assessment and brief intervention and includes other substances.
- 99408Audit/dast 15-30 min
- 99408 is the billing code counterpart for a comparable 15–30-minute service. G0396 is the Medicare HCPCS code.
G0396 billing questions
When should G0396 be used instead of G0397?
Use G0396 for a documented structured assessment and brief intervention lasting 15–30 minutes. G0397 is the longer-duration counterpart for services exceeding 30 minutes.
Does administering a screening questionnaire alone support G0396?
No. G0396 includes a brief intervention after the structured assessment; document the discussion or counseling that followed the assessment.
What documentation should support G0396?
Record the assessment method or instrument, results, intervention provided, total service time, and any referral or follow-up plan.
Can the same counseling time be counted toward an office visit and G0396?
Do not count the same work or time twice. Document the substance-use assessment and intervention distinctly from any separately reported evaluation and management service.
How many units of G0396 are reported for a 15–30-minute service?
G0396 represents the 15–30-minute service. Document the total time supporting that service; use G0397 when the service exceeds 30 minutes.
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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