G2076 HCPCS - INTAKE ACTIVITIES, INCLUDING INITIAL MEDICAL EXAMINATION THAT IS A COMPLETE, FULLY DOCUMENTED PHYSICAL EVALUATION AND INITIAL ASSESSMENT BY A PROGRAM PHYSICIAN OR A PRIMARY CARE PHYSICIAN, OR AN AUTHORIZED HEALTHCARE PROFESSIONAL UNDER THE SUPERVISION OF A PROGRAM PHYSICIAN QUALIFIED PERSONNEL THAT INCLUDES PREPARATION OF A TREATMENT PLAN THAT INCLUDES THE PATIENT'S SHORT-TERM GOALS AND THE TASKS THE PATIENT MUST PERFORM TO COMPLETE THE SHORT-TERM GOALS; THE PATIENT'S REQUIREMENTS FOR EDUCATION, VOCATIONAL REHABILITATION, AND EMPLOYMENT; AND THE MEDICAL, PSYCHO- SOCIAL, ECONOMIC, LEGAL, OR OTHER SUPPORTIVE SERVICES THAT A PATIENT NEEDS, CONDUCTED BY QUALIFIED PERSONNEL (PROVISION OF THE SERVICES BY A MEDICARE-ENROLLED OPIOID TREATMENT PROGRAM); LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE

Code Information

HCPCS Code: G2076
Sequence Number: 0010
Short Description: Intake act w/med exam
Long Description: Intake activities, including initial medical examination that is a complete, fully documented physical evaluation and initial assessment by a program physician or a primary care physician, or an authorized healthcare professional under the supervision of a program physician qualified personnel that includes preparation of a treatment plan that includes the patient's short-term goals and the tasks the patient must perform to complete the short-term goals; the patient's requirements for education, vocational rehabilitation, and employment; and the medical, psycho- social, economic, legal, or other supportive services that a patient needs, conducted by qualified personnel (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure
Date Added: 1/1/2020
Action Code: N - No maintenance for this code
Action Effective Date: 1/1/2020
Classification: Temporary Procedures & Professional Services
Coding System: HCPCS

Code Type

Berenson-Eggers Type Of Service Code: M5D - Specialist - other
Type Of Service Code:
- 1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96

Billing Information

Pricing Indicator Code:
- 13 - Price established by carriers (e.G., not otherwise classified, individual determination, carrier discretion)
Multiple Pricing Indicator Code: A - Not applicable as HCPCS priced under one methodology
Coverage Issues Manual Reference Section Number:
N/A
Medicare Carriers Manual Reference Section Number:
N/A
Coverage Code: C - Carrier judgment

HCPCS Record

Field Name	Field Value
Healthcare Common Procedure Coding System Code	G2076
HCPCS Sequence Number	0010
HCPCS Record Identification Code	3 - First line of procedure record also contains detail information in positions 92-275
HCPCS Long Description	Intake activities, including initial medical examination that is a complete, fully documented physical evaluation and initial assessment by a program physician or a primary care physician, or an authorized healthcare professional under the supervision of a program physician qualified personnel that includes preparation of a treatment plan that includes the patient's short-term goals and the tasks the patient must perform to complete the short-term goals; the patient's requirements for education, vocational rehabilitation, and employment; and the medical, psycho- social, economic, legal, or other supportive services that a patient needs, conducted by qualified personnel (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure
HCPCS Short Description	Intake act w/med exam
HCPCS Pricing Indicator Code 1	13 - Price established by carriers (e.G., not otherwise classified, individual determination, carrier discretion)
HCPCS Multiple Pricing Indicator Code	A - Not applicable as HCPCS priced under one methodology
HCPCS Coverage Code	C - Carrier judgment
HCPCS Berenson-Eggers Type Of Service Code	M5D - Specialist - other
HCPCS Type Of Service Code 1	1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96
HCPCS Anesthesia Base Unit Quantity	0
HCPCS Code Added Date	1/1/2020
HCPCS Action Effective Date	1/1/2020
HCPCS Action Code	N - No maintenance for this code

Code Information

Code Type

Billing Information

HCPCS Record

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