Summary & Overview
HCPCS G2073: Naltrexone Weekly Medication-Assisted Treatment Bundle
HCPCS Level II code G2073 denotes a weekly bundled service for medication assisted treatment using naltrexone, combining drug dispensing and/or administration with counseling, individual and group therapy, and toxicology testing when performed by a Medicare-enrolled opioid treatment program. The code captures a multidisciplinary package of services intended to support patients with opioid use disorder receiving naltrexone-based MAT. Nationally, bundled MAT codes are important as they reflect integrated care models and influence access to comprehensive treatment across payer types.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what the code represents, the clinical and service context for use, and which payers commonly cover this type of bundled MAT service. The publication also outlines expected benchmarks and policy context where available, including coverage patterns, site-of-service considerations, and implications for OTPs and outpatient substance use treatment programs.
This summary provides clinicians, billing staff, and policy stakeholders with a focused overview of the code’s purpose and scope, what to expect from payer coverage nationally, and the operational context for delivering bundled naltrexone MAT services in Medicare-enrolled OTP settings.
Billing Code Overview
HCPCS Level II code G2073 represents medication assisted treatment (naltrexone) provided as a weekly bundle. The bundled service includes dispensing and/or administration of naltrexone, substance use counseling, individual and group therapy, and toxicology testing if performed, when these services are provided by a Medicare-enrolled opioid treatment program.
Service type: Medication assisted treatment bundle (naltrexone), behavioral and monitoring services included.
Typical site of service: Medicare-enrolled opioid treatment program (OTPs) and other outpatient substance use treatment program settings where Medicare-enrolled OTPs provide bundled MAT services.
Clinical & Coding Specifications
Clinical Context
A 34-year-old patient with a history of opioid use disorder presents to a Medicare-enrolled opioid treatment program for continuation of medication-assisted treatment with extended-release injectable naltrexone. The patient receives weekly bundled services under G2073: medication dispensing/administration of naltrexone, brief individual counseling, participation in a weekly group therapy session, and point-of-care urine toxicology testing when indicated. The clinical workflow begins with a nurse or licensed clinician confirming eligibility and informed consent, administering or dispensing the weekly naltrexone dose, performing a urine toxicology test if clinically indicated, and delivering substance use counseling and psychotherapy either individually or in a group setting. Documentation includes medication administration record, counseling progress note, group attendance, and toxicology results. Billing is submitted by the Medicare-enrolled opioid treatment program using G2073 to capture the bundled weekly services provided to the patient.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no other modifier applies to the claim |