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See a sample rate comparisonHCPCS G0442 Fee Schedule
Medicare rates as of October 2026
HCPCS G0442 is classified under Procedures / Professional Services, in the Counseling, Screening, and Prevention Services subgroup.
Annual alcohol misuse screening, 5 to 15 minutes
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Counseling, Screening, and Prevention Services |
| Hospital Outpatient Group (APC) | APC 5821 - Level 1 Health and Behavior Services |
| Common Revenue Codes | 05100521Sign up to view all 3 |
| Medicare Fee Schedule | $18.71 national non-facility rate (2026)View Medicare rates for G0442 |
| Medicaid Fee Schedule | $15.195 median of the 8 states in the free previewView Medicaid rates for G0442 |
National average reimbursement for HCPCS G0442 by major payers:
$21.12
BCBS / Anthem
$23.45
UnitedHealthcare
$20.39
Aetna
$20.61
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G0442.
HCPCS G0442
5 of 25 sample ratesHigher to lower in this preview
Slidell Memorial Hospital, Md Imaging Slidell
Slidell Memorial Hospital
$57.56Published rateLallie Kemp Medical Ctr, Lallie Kemp Regional Medical Center
$42.24Published rateSabine Medical Center
$31.06Published rateBama Heart Doc, P.C., Alabama Heart And Vascular Medicine
Bama Heart Doc, PC Dba Alabama Heart & Vascular Medicine
$18.95Published rateCarolina Radiology Associates LLC
Carolina Radiology Associates, LLC
$7.98Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0442 vs. Other Counseling, Screening, and Prevention Services Codes
The table lists codes related to G0442. Select one to see its fee schedule.
| Code | Description |
|---|---|
| G0439-HCPCS | Annual wellness visit, includes a personalized prevention plan of service (PPPS), subsequent visit |
| G0442-HCPCS | Annual alcohol misuse screening, 5 to 15 minutes |
| G0443-HCPCS | Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0442. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0442 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 G0442 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns HCPCS G0442 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 G0442?
Hospital price transparency files list HCPCS G0442 under these revenue codes: 0510, 0521 and 0983. A revenue code names the hospital department or charge category for the line; it does not change what the service is.