HCPCS code G2086
Office-based treatment for opioid use disorder, including development of the treatment plan, care coordination, individual therapy and group therapy and counseling; at least 70 minutes in the first calendar month
What G2086 means
G2086 (Off base opioid tx 70min) belongs to the HCPCS Level II G series (Procedures / Professional Services (Temporary)). Its Medicare coverage status is Carrier judgment. Medicare coverage is left to the judgment of the local Medicare Administrative Contractor (MAC), so check your MAC's local coverage determinations.
Part B pricing: Price established by carriers (e.g., not otherwise classified, individual determination, carrier discretion).
Code details
- Short description
- Off base opioid tx 70min
- Coverage code
- C = Carrier judgment
- Pricing indicator
- 13 = Price established by carriers (e.g., not otherwise classified, individual determination, carrier discretion)
- Multiple pricing indicator
- A = Not applicable as HCPCS priced under one methodology
- Type of service
- 1 = Medical care
- Action code
- N = No maintenance for this code
- Action effective date
- January 01, 2020
- Code added date
- January 01, 2020
- Data year
- 2026
Questions about G2086
What is HCPCS code G2086?
HCPCS code G2086 is a Level II code in the G series (Procedures / Professional Services (Temporary)). Its full description is: "Office-based treatment for opioid use disorder, including development of the treatment plan, care coordination, individual therapy and group therapy and counseling; at least 70 minutes in the first calendar month"
Is G2086 a CPT code?
No. G2086 is a HCPCS Level II code maintained by CMS, not a CPT (Level I) code from the American Medical Association. People often search for it as a CPT code because both code sets are reported on the same claims.
Does Medicare cover HCPCS code G2086?
The Medicare coverage code for G2086 is "Carrier judgment". Medicare coverage is left to the judgment of the local Medicare Administrative Contractor (MAC), so check your MAC's local coverage determinations.
When was HCPCS code G2086 added?
G2086 was added to the HCPCS code set on January 01, 2020. The most recent action on it (No maintenance for this code) took effect on January 01, 2020.
Nearby G codes
All G codes- G2079Take-home supply of buprenorphine (oral); up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure
- G2080Each additional 30 minutes of counseling in a week of medication assisted treatment, (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure
- G2081Patients age 66 and older in institutional special needs plans (snp) or residing in long-term care with a pos code 32, 33, 34, 54 or 56 for more than 90 consecutive days during the measurement period
- G2082Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of up to 56 mg of esketamine nasal self-administration, includes 2 hours post-administration observation
- G2083Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self-administration, includes 2 hours post-administration observation
- G2087Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month
- G2088Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; each additional 30 minutes beyond the first 120 minutes (list separately in addition to code for primary procedure)
- G2089Most recent hemoglobin a1c (hba1c) level 7.0 to 9.0%
- G2090Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period
- G2091Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period