G2011 Alcohol/sub misuse assess

Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention, 5-14 minutes

Medically Unlikely Edits (effective October 1, 2026)

Medicare pricing for G2011

Physician Fee Schedule (CY 2026, RVU26D)

Status A: active, paid separately under the PFS if covered. National amounts: non-facility $17.37, facility $14.70 (total RVUs 0.52 / 0.44 × $33.4009 conversion factor). Work RVU 0.33, practice expense RVU 0.16 non-facility and 0.08 facility, malpractice RVU 0.03. Global period XXX. Qualifying APM participants are paid at a $33.5675 conversion factor.

Payer policies and prior authorization for G2011

Payer coverage policies that name G2011

G2011 appears in 1 coverage policy from Premera Blue Cross.

PayerPolicyRole in policyReviewedDocument
Premera Blue CrossPreventive Care
Alcohol misuse screening and counseling care Unhealthy Drug Use screening		listed, no stanceSep 21, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • IL: $11.44 (practitioner), effective Apr 1, 2024
  • ND: $0.00 (physician), effective Aug 1, 2026
  • OH: $13.27 (physician), effective Jan 1, 2019
  • TX: $12.05 (certified_nurse_midwife_cnm, Certified Nurse Midwife (Cnm), facility), effective Sep 1, 2022
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $12.79 (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.