$18.40–$21.27
G0442 is the annual alcohol misuse screening; G0443 is counseling after a positive screen when a counseling intervention is provided.
On this page
CMS RVU26D · Effective 2026-10-01
G0443 Alcohol counseling Medicare reimbursement rates in Virginia
G0443 reports a brief, face-to-face counseling service for a patient identified through alcohol misuse screening as needing behavioral guidance. Compare G0443 office and facility rates across CMS payment localities in Virginia.
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 G0443 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$33.79–$37.95
2 of 2 localities have a supported rate.
Facility setting
$25.91–$28.51
2 of 2 localities have a supported rate.
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.
Preventive counseling
About G0443: Brief alcohol misuse counseling
G0443 reports a brief, face-to-face counseling service for a patient identified through alcohol misuse screening as needing behavioral guidance.
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.
Where the value comes from
- Work RVU0.60 · 58%
- Practice expense (office) RVU0.39 · 38%
- Malpractice RVU0.04 · 4%
3K
Medicare services in 2024 · #2171 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.
G0443 compared with similar codes
Office rates for Virginia, from the same CMS release.
99408
No office rateAudit/dast 15-30 min
99408 describes structured screening and brief intervention under CPT time-based criteria. G0443 is the Medicare HCPCS code for brief alcohol misuse counseling.
99409
No office rateAudit/dast over 30 min
99409 is the longer-time CPT screening and brief intervention service. G0443 represents the brief Medicare alcohol counseling service.
Compare G0443 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
$37.95
Facility
$28.51
Virginia →
Office / nonfacility
$33.79
Facility
$25.91
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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 CPT 99408 or 99409?
G0443 is the Medicare HCPCS code for brief alcohol misuse counseling. CPT 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 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.
15,260G0438,,"Ppps, initial visit",A,,2.60,2.45,,2.45,NA,0.17,5.22,5.22,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,261G0439,,"Ppps, subseq visit",A,,1.92,2.07,,2.07,NA,0.13,4.12,4.12,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,262G0442,,Annual alcohol screen 15 min,A,,0.18,0.37,,0.05,,0.01,0.56,0.24,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,263G0443,,Brief alcohol misuse counsel,A,,0.60,0.39,,0.15,,0.04,1.03,0.79,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,264G0444,,Depression screen annual,A,,0.18,0.37,,0.05,,0.01,0.56,0.24,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,265G0445,,High inten beh couns std 30m,A,,0.60,0.39,,0.16,,0.04,1.03,0.80,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,266G0446,,Intens behave ther cardio dx,A,,0.60,0.38,,0.15,,0.04,1.02,0.79,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00