Summary & Overview
HCPCS G2067: Methadone Medication Assisted Treatment Weekly Bundle
HCPCS Level II code G2067 designates a weekly bundle for methadone-based medication assisted treatment (MAT) delivered by Medicare-enrolled opioid treatment programs. The code captures a comprehensive week of care, including methadone dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing when performed. This consolidated billing construct matters nationally as methadone MAT is a core evidence-based intervention for opioid use disorder and billing clarity affects access, program operations, and payer reimbursement workflows.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise national overview of the clinical services represented by the code, payer coverage context, and what to expect in policy and billing workflows. The publication covers benchmarks where available, recent policy updates affecting bundled MAT services, and clinical context linking the coded service to standard OTP care models.
The analysis provides practical reference material for coding professionals, health policy analysts, and program administrators seeking to understand how a weekly methadone bundle is represented in claims, how major payers approach coverage, and the operational implications for OTPs and outpatient substance use treatment programs. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code G2067 describes a medication assisted treatment (MAT) weekly bundle for methadone provided by a Medicare-enrolled opioid treatment program. The code encompasses weekly dispensing and/or administration of methadone along with substance use counseling, individual and group therapy, and toxicology testing when performed.
Service Type: Medication assisted treatment (methadone) — weekly bundle
Typical Site of Service: Opioid treatment program (OTP) or other Medicare-enrolled substance use treatment facility that provides methadone dispensing/administration and integrated counseling and testing services
Clinical & Coding Specifications
Clinical Context
A 38-year-old patient with opioid use disorder presents to a Medicare-enrolled opioid treatment program for ongoing medication assisted treatment using methadone. The patient arrives for a weekly visit where clinic staff perform medication dispensing and/or direct administration of methadone, provide substance use counseling, coordinate individual or group therapy sessions during the week, and obtain urine toxicology testing if indicated. The clinical workflow includes initial intake by a licensed clinician, review of treatment plan and dosing by a prescriber, supervised dispensing or observed dosing of methadone by a qualified medication technician or nurse, delivery of counseling and behavioral therapy by licensed counselors or social workers, documentation of urine drug screen results in the medical record, and weekly care coordination including medication monitoring and adjustments as needed. The service is billed as a bundled weekly episode under G2067 when provided by a Medicare-enrolled opioid treatment program.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Procedure or service, no modifier | Use when no modifier applies and billing the standard bundled weekly service. |
22 |