Commonly Used Addiction Billing Codes | CASAColumbia

Commonly Used Billing Codes

What billing codes can I use?

Insurance coverage of addiction treatment remains severely limited in both the populations and services that are covered. The absence of mandated coverage in all health plans means that some health plans may continue to choose not to provide coverage for addiction treatment, continuing to deny access to patients who need it.

A list of current billing codes is provided below:

Billing Codes Payer Commercial Insurance

  Payer: Commercial Insurance  
Code Description Fee Schedule
CPT 99406 Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes, up to 10 minutes 12.18 to $15.26*
CPT 99407 Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes $25.79 to $30.14*
CPT 99408 Alcohol and/or substance (other than tobacco) abuse structured screening (e.g., AUDIT, DAST), and brief intervention (SBI) services; 15 to 30 minutes $33.41**
CPT 99409 Alcohol and/or substance (other than tobacco) abuse structured screening (e.g., AUDIT, DAST), and brief intervention (SBI) services; greater than 30 minutes $65.51**
  Payer: Medicare  
Code Description Fee Schedule
G0436 Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes $12.18 to $15.65*
G0437 Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes $26.15 to $30.92*
G0396 Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g., AUDIT, DAST), and brief intervention, 15 to 30 minutes $34.75-$40.31*
G0397 Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g., AUDIT, DAST) and intervention greater than 30 minutes $68.42-$77.49*
G0442 Annual alcohol misuse screening, 15 minutes $9.67 to $19.57*
G0443 Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes $24.00 to $28.18*
  Payer: Medicaid  
Code Description Fee Schedule
H0049 Alcohol and/or drug screening $24.00**
H0050 Alcohol and/or drug service, brief intervention, per 15 minutes $48.00**

Adapted from:

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