`G0443` Brief alcohol misuse counsel

Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes

Medicare coverage: Carrier judgment
Status: active (October 2026 file)

Medically Unlikely Edits (effective October 1, 2026)

Practitioner: max 1 units per day (policy), rationale: CMS Policy
Outpatient hospital: max 1 units per day (policy), rationale: CMS Policy

Medicare pricing for G0443

Physician Fee Schedule (CY 2026, RVU26D)

Status A: active, paid separately under the PFS if covered. National amounts: non-facility $34.40, facility $26.39 (total RVUs 1.03 / 0.79 × $33.4009 conversion factor). Work RVU 0.60, practice expense RVU 0.39 non-facility and 0.15 facility, malpractice RVU 0.04. Global period XXX. Qualifying APM participants are paid at a $33.5675 conversion factor.

Payer policies and prior authorization for G0443

Payer coverage policies that name G0443

G0443 appears in 2 coverage policies from Premera Blue Cross, UnitedHealthcare.

Payer	Policy	Role in policy	Reviewed	Document
Premera Blue Cross	Preventive Care Alcohol misuse screening and counseling care Unhealthy Drug Use screening	listed, no stance	Sep 21, 2026	payer document
UnitedHealthcare	Preventive Care Services (MP.016.59) USPSTF Rating (Nov. 2018): B	listed, no stance	Jul 1, 2026	payer document

Medicaid fee-for-service

IN: $23.62 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
LA: $22.33 (professional), effective Sep 8, 2023
ND: $0.00 (physician), effective Aug 1, 2026
VT: $78.88 (outpatient_hospital_opps), effective Feb 1, 2026
WY: $44.93 (outpatient_hospital_apc, Ambulatory Surgical Centers), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.

G0443 Brief alcohol misuse counsel