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See a sample rate comparisonHCPCS G0396 Fee Schedule
Medicare rates as of October 2026
HCPCS G0396 is classified under Procedures / Professional Services, in the Alcohol and Substance Abuse Assessments subgroup.
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Alcohol and Substance Abuse Assessments |
| Hospital Outpatient Group (APC) | APC 5821 - Level 1 Health and Behavior Services |
| Common Revenue Codes | 09000510Sign up to view all 3 |
| ASAM Level | Level 0.5 - Early Intervention |
| Care Type | Screening |
| Setting | Outpatient |
| Medicare Fee Schedule | $37.08 national non-facility rate (2026)View Medicare rates for G0396 |
| Medicaid Fee Schedule | $31.22 median of the 8 states in the free previewView Medicaid rates for G0396 |
National average reimbursement for HCPCS G0396 by major payers:
$42.44
BCBS / Anthem
$42.59
UnitedHealthcare
$36.17
Aetna
$37.02
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G0396.
HCPCS G0396
5 of 25 sample ratesHigher to lower in this preview
Arthur M. Blank Hospital, Inc., Arthur M. Blank Hospital
Childrens Healthcare Of Atlanta Inc
$121.73Published rateChristopher Raio
Mercy Medical Center
$58.73Published rateChristopher Raio
Mercy Medical Center
$55.20Published rateJulie Webster
Musc Community Physicians
$38.93Published rateBrittany Ptachick
Hroa 401k Plan
$26.66Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0396 vs. Other Alcohol and Substance Abuse Assessments Codes
The table lists codes related to G0396. Select one to see its fee schedule.
| Code | Description |
|---|---|
| G0390-HCPCS | Trauma response team associated with hospital critical care service |
| G0396-HCPCS | Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
| G0397-HCPCS | Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0396. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0396 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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Frequently Asked Questions
What APC is HCPCS G0396 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns HCPCS G0396 to APC 5821 (Level 1 Health and Behavior Services). An APC groups outpatient services that Medicare pays at the same base rate.
Which revenue codes are billed with HCPCS G0396?
Hospital price transparency files list HCPCS G0396 under these revenue codes: 0900, 0510 and 0940. A revenue code names the hospital department or charge category for the line; it does not change what the service is.