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See a sample rate comparisonHCPCS G0397 Fee Schedule
Medicare rates as of October 2026
HCPCS G0397 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 intervention, greater than 30 minutes
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Alcohol and Substance Abuse Assessments |
| Hospital Outpatient Group (APC) | APC 5823 - Level 3 Health and Behavior Services |
| Common Revenue Codes | 09000940 |
| ASAM Level | Level 0.5 - Early Intervention |
| Care Type | Screening |
| Setting | Outpatient |
| Medicare Fee Schedule | $67.47 national non-facility rate (2026)View Medicare rates for G0397 |
| Medicaid Fee Schedule | $58.805 median of the 8 states in the free previewView Medicaid rates for G0397 |
National average reimbursement for HCPCS G0397 by major payers:
$83.29
BCBS / Anthem
$81.59
UnitedHealthcare
$68.37
Aetna
$71.32
Cigna
Compare published rates across providers.
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HCPCS G0397
5 of 25 sample ratesHigher to lower in this preview
Slidell Memorial Hospital, St Tammany Parish Hospital Service District #2
Slidell Memorial Hospital
$331.54Published rateJacob Holloway
$137.83Published rateJulie Webster
Musc Community Physicians
$90.12Published rateVictoria Lewis-Holland
$73.20Published rateMiguel Arenas
Miguel A Arenas Md PC
$53.06Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0397 vs. Other Alcohol and Substance Abuse Assessments Codes
The table lists codes related to G0397. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 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 |
| G0398-HCPCS | Home sleep study test (HST) with type II portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0397. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0397 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 G0397 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns HCPCS G0397 to APC 5823 (Level 3 Health and Behavior Services). An APC groups outpatient services that Medicare pays at the same base rate.
Which revenue codes are billed with HCPCS G0397?
Hospital price transparency files list HCPCS G0397 under these revenue codes: 0900 and 0940. A revenue code names the hospital department or charge category for the line; it does not change what the service is.