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 HCPCS code G0137: Intensive outpatient services; minimum of nine services over a 7 - contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under State law); occupational therapy requiring the skills of a qualified occupational therapist; services of social  workers, trained psychiatric nurses, and other staff trained to work with psychiatric patients; drugs and biologicals furnished for therapeutic purposes, excluding opioid agonist and antagonist medications that are FDA -approved for use in treatment of OUD or opioid antagonist medications for the emergency treatment of known or suspected opioid overdose; individualized activity therapies that are not primarily recreational or diversionary; family counseling (the primary purpose of which is treatment of the individuals condition); patient training and education (to the extent that training and educational activities are closely and clearly related to individuals care and treatment); diagnostic services (not including toxicology testing); (provision of the services by a Medicare -enrolled Opioid Treatment Program); List  separately in addition to code for primary procedure, if applicable    HCPCS code G2076: Intake activities, including initial medical examination that is a complete, fully documented physical evaluation and initial assessment conducted by a program physician or a primary care physician,  or an authorized  healthcare  professional  under  the supervision of a program  physician or qualified personnel that includes preparation of a treatment plan that includes the patients short -term goals and the tasks the patient must perform to complete the short -term goals; the patients requirem ents 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 Tr eatment Program); List separately in addition to code for primary procedure.    HCPCS  code  G2077:  Periodic  assessment;  assessing  periodically  by qualified  personnel  to determine  the most appropriate combination of services and treatment (provision of the services by a Medicare -enrolled Opioid Treatment Program); List separately in addition to code for primary procedure.    HCPCS code G2078: Take -home supply of methadone; up to 7 additional day supply (provision of the services  by a Medicare- enrolled Opioid Treatment Program); List separately  in addition to code  for primary procedure.    HCPCS  code  G2079:  Take- home  supply of buprenorphine  (oral);  up to 7 additional  day supply (provision of the services by a Medicare -enrolled Opioid Treatment Program); List separately in addition to code for primary procedure.    HCPCS  code  G2080:  Each  additional  30 minutes  of counseling or group or  individual  therapy  in a week of medication assisted treatment, (provision of the services by a Medicare -enrolled Opioid Treatment Program); List separately in addition to code for primary procedure.    HCPCS code G2215: Take -home supply of nasal naloxone; 2- pack of 4mg per 0.1 mL nasal spray (provision of the services by  a Medicare- enrolled Opioid Treatment  Program); List separately  in addition to code for primary procedure.    HCPCS  code  G2216:  Take- home  supply of injectable naloxone  (provision of  the services  by a Medicare-  enrolled Opioid Treatment Program); List separately in addition to code for primary procedure.    HCPCS code G1028: Take -home supply of nasal naloxone; 2- pack of 8mg per 0.1 mL nasal spray (provision of the services by  a Medicare- enrolled Opioid Treatment  Program); List separately  in addition to code for primary procedure.   30.7 - Cost Sharing (Rev. 10665: Issued; 03- 16-21: Effective; 01 -01-21: Implementation: 04 -15-21)  There is zero beneficiary copayment for the codes billed by OTPs.  However, the Part B deductible does apply, as mandated for all Part B services by section 1833(b) of the Act.    30.8 - Locality Adjustments (Rev. 12418; Issued: 12- 21-23; Effective: 01 -01-24; Implementation: 01- 24-24)  The payment amounts for the non- drug component of the bundled payment for an episode of care, and the adjustments for counseling or therapy, intake activities, periodic assessments, take -home supplies of naloxone, and intensive outpatient program services  (HCPCS codes G2067- G2077, G2080, G2215, G2216, G1028, and G0137) will be geographically adjusted using the Geographic Adjustment Factor (GAF). Additionally, for purposes of the GAF, OUD treatment services that are furnished via an OTP mobile unit will be treated as if they were furnished at the physical location of the OTP registered with the Drug Enforcement Administration (DEA) and certified by SAMHSA.   30.9 - Annual Updates    The payment  amounts  for the non-drug component  of the bundled payment for  an episode  of care, and  the adjustments for counseling or therapy, intake activities, periodic assessments, and intensive outpatient program services (HCPCS codes G2067-  G2077, G2080, and G0137) will be updated annually using the Medicare Economic Index.   40 - Practitioner Claims submission   A/B MAC (B)                                                        (Rev. 12418; Issued: 12- 21-23; Effective: 01 -01-24; Implementation: 01- 24-24) Beginning January  1, 2020, claims for OTP services are submitted using the 837P transaction to transmit health care claims electronically, or using the CMS -1500 (the paper version of the 837P). Beginning January 1, 2021, OTPs may apply on the Medicare Enrollment Application for Institutional Providers (CMS -855A)  or through the Internet -based  Provider  Enrollment,  Chain  and Ownership  System  (PECOS)(837I) when  they  enroll  in the Medicare Program.  These providers will  submit  claims  using the CMS -1450.   HCPCS  codes  G2067- G2075, and G0137, cover  episodes  of care of 7 continuous  days and cannot  be billed  for the same patient more than once per 7 continuous day period.   HCPCS  codes  G2076- G2080 are add-on codes  that are billed  in addition to one of the base bundle  codes (Rev. 12418; Issued: 12 -21-23; Effective: 01 -01-24; Implementation: 01 -24-24) described by HCPCS codes G2067- G2075.   Consistent  with FDA  labeling, HCPCS  codes  G2069 and G2073 should not be used more  than once every  4 weeks and HCPCS codes G2070 and G2072 should not be used more than once every 6 months. HCPCS  codes  G2078 and G2079 may be billed  in multiple  units, up to 3 in one month (in addition to the base bundle code).  HCPCS  codes  G2215 and G2216 are limited  to being billed  once  every  30 days, however, exceptions  to this limit are allowed in the case where the beneficiary overdoses and uses the initial supply of naloxone dispensed by the OTP to the extent that it is medically reasonable and necessary to furnish additional naloxone. If an additional supply of naloxone is needed within 30 days of the original supply being provided, OTPs must document in the medical record the reason for the exception.  HCPCS  code  G2216 (injectable  naloxone)  is contractor -priced for  CY 2021.  Patients may be appropriately given OUD services at more than one OTP within a 7 day period in certain limited  clinical  situations, such as for guest  dosing or when  a patient  transfers  care between  OTPs.  Each  of the  involved OTPs  may bill the appropriate  HCPCS  codes  for the services  provided to the patient,  but both OTPs must maintain sufficient medical record documentation to reflect the clinical situation and services provided.   In instances in which a patient is switching from one drug to another, the OTP should only bill for one code describing a weekly  bundled payment  for that week  and should determine  which  code  to bill based on which drug was furnished for the majority of the week.   40.1 - Place of Service  (Rev. 4524: Issued; 02- 14-20: Effective; 01 -01-20: Implementation: 03 -16-20)  Claims for OTP services should use Place of Service code 58 (Non -residential Opioid Treatment Facility  a location that provides treatment for OUD on an ambulatory basis. Services include methadone and other forms of MAT).   40.2 - Date of Service  (Rev. 12418; Issued: 12- 21-23; Effective: 01 -01-24; Implementation: 01- 24-24)  For the codes that describe a weekly bundle (HCPCS codes G2067- G2075) as well as HCPCS code G0137, one week is defined as 7 contiguous  days. OTPs  may  choose  to apply a standard billing  cycle by setting  a particular  day of the  week to begin all episodes of care.  In this case, the date of service would be the first day of the OTPs billing cycle. If a beneficiary starts treatment at the OTP on a day that is in the middle of the OTPs standard weekly billing cycle, the OTP may still bill the applicable code for that episode of care provided that the threshold to bill for the code has been met.  Alternatively, OTPs may choose to adopt weekly billing cycles that vary across patients. Under this approach,  the initial date of  service will depend  upon the day of the week  when  the patient  was first  admitted to the program or when Medicare billing began. Therefore, under this approach of adopting weekly billing cycles that vary across patients, when a patient is beginning treatment or re -starting treatment after a break  in treatment, the date of service would reflect the first day the patient was seen and the date of service for subsequent consecutive episodes of care would be the first day after the previous 7- day period ends.  For the codes describing add- on services (HCPCS codes G2076- G2080, and G0137), the date of service should reflect the  date that service was furnished;  however, if the OTP  has chosen  to apply a standard weekly  billing  cycle, the date of service for codes describing add -on services may be the same as the first day in the weekly billing cycle.   40.3 - Prescribing Individuals  (Rev. 4524: Issued; 02- 14-20: Effective; 01 -01-20: Implementation: 03 -16-20)  OTPs should list the prescribing or medication ordering physicians or other eligible professionals National Provider Identifier in Field 17 (the ordering/referring/other field) of the Form CMS 1500 (Health Insurance Claim Form; 0938 1197) or the digital equivalent thereof.   50  Institutional Opioid Treatment Program (OTP) Services   A/B MAC (A)  (Rev. 10521; Issued: 12- 16-20; Effective: 01 -01-21; Implementation: 01 -04-21)   Medicare Part B coverage is available for outpatient Opioid Treatment Program services provided by hospitals, CAHs, and Free -Standing Opioid Treatment Program facilities.   50.1  Special Opioid Treatment Program Billing Requirements for Hospitals, Critical Access Hospitals, and Free -Standing Opioid Treatment Program Facilities  (Rev. 10521; Issued: 12- 16-20; Effective: 01 -01-21; Implementation: 01 -04-21)   Medicare Part B coverage is available for hospital outpatient Opioid Treatment Program services. A. Billing Requirement  Section 1861(s)(2)(HH)(jjj) of the Act requires that opioid use disorder treatment services would include the Food and Drug Administration (FDA)-approved opioid agonist and antagonist treatment medications, the dispensing and administration of such medicat ions (if applicable), substance use disorder counseling, individual and group therapy, toxicology testing, and other items and services that the Secretary determines are appropriate. Section 1861(s)(2)(HH)(jjj) defines OTPs as those that enroll in Medicare  and are certified by the Substance Abuse and Mental Health Services Administration (SAMHSA), accredited by a SAMHSA -approved entity, and meet additional conditions as the Secretary finds necessary to ensure the health and safety of individuals being furni shed services under these programs and the effective and efficient furnishing of such services.