Summary & Overview
HCPCS G2074: Medication Assisted Treatment Weekly Bundle (Non-Drug)
HCPCS Level II code G2074 designates a weekly bundled service for medication assisted treatment (MAT) that excludes the pharmaceutical component and is billed by Medicare-enrolled opioid treatment programs. The bundle typically includes substance use counseling, individual and group therapy, and toxicology testing when performed, consolidating non-drug clinical services into a single weekly code. Nationally, this code matters because it standardizes billing for supportive services critical to opioid use disorder treatment and affects how programs document and receive payment for non-pharmacologic care.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of what the code represents, payer coverage context, and the clinical settings where the code is used. The publication outlines expected service components, typical site of service, and common modifier usage where available. It also provides benchmarking and policy context for program billing practices and places the code within the broader landscape of opioid use disorder services.
The report is intended for billing managers, compliance officers, and clinical program administrators seeking concise guidance on the purpose and application of HCPCS Level II code G2074 at a national level. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code G2074 represents a medication assisted treatment (MAT) weekly bundle that excludes the medication itself. The code covers the provision of services by a Medicare-enrolled opioid treatment program, and typically includes substance use counseling, individual and group therapy, and toxicology testing if performed.
Service type: Behavioral health and substance use disorder treatment bundle (non-drug services)
Typical site of service: Opioid treatment program (OTPs) or outpatient substance use treatment clinics enrolled in Medicare
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 ongoing medication assisted treatment (MAT). The program provides weekly bundled services under G2074, which excludes the medication cost itself. The patient arrives for a scheduled weekly visit that includes a brief medical check-in, individual substance use counseling, participation in a group therapy session, and point-of-care urine toxicology screening when indicated. The clinical workflow: registration and verification of Medicare eligibility; intake vitals and brief assessment by nursing staff; medication dispensing arranged separately by the program (medication cost billed outside G2074); a 20–30 minute individual counseling session documented in the patient record; a 45–60 minute group therapy session; and a urine toxicology test if clinically indicated with results documented. Progress notes document counseling content, treatment adherence, toxicology results, and any care coordination or referrals. Billing uses G2074 for the weekly bundle of psychosocial services and testing provided by the enrolled opioid treatment program, with appropriate modifiers appended as needed for specific circumstances.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 |