Summary & Overview
HCPCS G2075: Medication Assisted Treatment Weekly Bundle
HCPCS Level II code G2075 represents a weekly bundled payment for medication assisted treatment (MAT) delivered by Medicare-enrolled opioid treatment programs (OTPs). The bundle covers medication dispensing and/or administration and often includes substance use counseling, individual and group therapy, and toxicology testing when performed. This code matters nationally as policymakers and payers focus on access to evidence-based treatment for opioid use disorder and on structuring payments that reflect multidisciplinary care.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical services packaged by the code, typical site-of-service considerations, and the implications for billing workflows. The analysis highlights how bundled coding like G2075 aligns payment with comprehensive OTP services and what administrators should note about coverage scope and service delivery under this code.
The publication provides benchmarks where available, summarizes recent policy and reimbursement developments affecting bundled MAT services, and outlines clinical context to clarify which service elements are commonly included in the weekly bundle. Data not available in the input will be identified as such in the detailed sections.
Billing Code Overview
HCPCS Level II code G2075 describes a medication assisted treatment weekly bundle provided by a Medicare-enrolled opioid treatment program. The code covers a package of services that may include dispensing and/or administration of medication, substance use counseling, individual and group therapy, and toxicology testing, if performed.
Service type: Medication assisted treatment (weekly bundled services)
Typical site of service: Medicare-enrolled opioid treatment program (OTP) facility
Clinical & Coding Specifications
Clinical Context
A 34-year-old patient with opioid use disorder presents to a Medicare-enrolled opioid treatment program for weekly medication-assisted treatment. The patient receives observed dosing and/or take-home dispensing of an opioid agonist or antagonist medication, participates in individual counseling and group therapy sessions during the week, receives substance use counseling, and undergoes urine toxicology testing when scheduled. The clinical workflow begins with intake and assessment by a licensed clinician (physician, nurse practitioner, or physician assistant) who documents diagnosis, treatment plan, and medication selection. Nursing staff or a licensed dispenser administers or dispenses medication per program policy. Behavioral health clinicians provide individual and group therapy and document counseling content and frequency. Toxicology testing is collected and processed per program protocols; results are reviewed by the clinical team and documented. Weekly bundle billing for G2075 is submitted by the Medicare-enrolled opioid treatment program to cover the integrated set of services (dispensing/administration, substance use counseling, individual and group therapy, and toxicology testing) delivered during that week.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when services required substantially greater work than normally required for the procedure, with documentation justifying unusual effort or time. |