Summary & Overview

HCPCS G2087: Office-Based Opioid Use Disorder Treatment, 60+ Minutes

HCPCS Level II code G2087 denotes office-based treatment for opioid use disorder that includes care coordination, individual therapy, and group therapy or counseling for at least 60 minutes in a subsequent calendar month. This code captures ongoing outpatient behavioral health services aimed at maintaining engagement in medication-assisted treatment and psychosocial support. Nationally, the code matters as payers and providers seek consistent ways to bill for extended monthly psychotherapy and coordination services tied to opioid use disorder care.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical intent, typical site of service, and service type. The publication also summarizes what to expect from payer coverage patterns and billing practice benchmarks where available, highlights recent policy updates affecting outpatient substance use disorder billing, and provides clinical context for how G2087 fits within ongoing treatment models. Data not available in the input will be noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareG2087HCPCS Level IIopioid use disorderbehavioral healthoutpatient treatmentcare coordinationtherapybilling

Billing Code Overview

HCPCS Level II code G2087 represents office-based treatment for opioid use disorder, delivered in a follow-up month and lasting at least 60 minutes. The service description includes care coordination, individual therapy, and group therapy and counseling, reflecting comprehensive outpatient behavioral health management for patients receiving ongoing treatment for opioid use disorder.

Service type: Office-based opioid use disorder treatment involving psychotherapy and care coordination
Typical site of service: Outpatient office or clinic setting providing ongoing substance use disorder treatment

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 34-year-old patient with a history of opioid use disorder (OUD) established care in an office-based addiction medicine clinic is seen for a follow-up treatment visit in the second month after treatment initiation. The patient receives medication management (e.g., buprenorphine), individual counseling, group counseling coordination, and care coordination with community resources. The visit includes medication reconciliation, assessment of craving and withdrawal, behavioral counseling (individual and brief group facilitation), coordination with a case manager for housing and vocational services, and documentation of treatment progress. Total face-to-face clinician time for OUD-related services during the calendar month exceeds 60 minutes, qualifying for billing under G2087 for office-based treatment of opioid use disorder in a subsequent calendar month.

Typical clinical workflow:

Patient checks in and completes brief standardized questionnaires (PHQ-9, opioid withdrawal checklist).
Nurse or medical assistant obtains vitals, performs urine drug testing if indicated, and documents medication adherence.
Prescribing clinician conducts focused history and examination, adjusts medications as needed, documents risk mitigation (PDMP check, counseling on naloxone), and provides prescriptions.
Behavioral health clinician provides individual therapy and documents at least 60 minutes of OUD-focused counseling across the month (may include group sessions and care coordination efforts).
Case manager documents referrals and interactions with community resources and updates the care plan.
Billing staff appends G2087 for the subsequent month when the combined OUD-focused services meet the 60-minute threshold and applies appropriate modifiers for payer requirements.

Coding Specifications

Modifier	Description	When to Use
`11`	Professional component	Use when reporting the professional component of a service distinct from an institutional component, if applicable per payer rules.
`22`	Increased procedural services	Use when services required substantially greater work than typically required for this code (document rationale).
`23`	Unusual anesthesia	Rarely applicable; use only if unusual anesthesia-related circumstances occur during an office-based procedure tied to OUD care.
`29`	Service furnished unrelated to the primary procedure	Use when a service at the same session is unrelated to the primary OUD service and must be indicated as distinct.
`52`	Reduced services	Use when the service provided is partially reduced or discontinued at the clinician’s discretion.
`53`	Discontinued procedure	Use when the procedure was started but discontinued, with documentation of the reason.
`62`	Two surgeons	Use when two surgeons share responsibility; seldom used for office-based OUD treatment but included for completeness when surgical overlap occurs.
`78`	Return to OR for related procedure during post-op period	Not typical for OUD office visits; use only if a related return occurs.
`95`	Synchronous telemedicine service rendered via real-time interactive audio and video	Use when `G2087`-level services are rendered via telehealth modalities allowed by the payer and meet the 60-minute requirement.
`GT`	Via interactive audio and video telecommunication systems	Use for telehealth delivery when payer recognizes `GT` for telemedicine encounters.
`GQ`	Asynchronous telemedicine service (store-and-forward)	Use when aspects of care coordination or counseling are delivered asynchronously per payer rules.
`G0`	Telehealth services for federally declared public health emergency	Use when telehealth OUD services are provided under public health emergency allowances.
`82`	Assistant surgeon when a qualified resident surgeon is not available	Rare for OUD office-based care; included only for completeness in settings with procedural overlap.
`25`	Significant, separately identifiable E/M service by the same physician on the same day of the procedure/service	Use when a significant separate E/M visit occurs on the same day as another procedure or service billed.

Taxonomy Code	Specialty	Notes
`2084P0800X`	Addiction Medicine Physician	Physicians specializing in medication-assisted treatment and office-based OUD care.
`208D00000X`	Psychiatry & Neurology	Psychiatrists providing medication management and psychotherapy for OUD.
`208U00000X`	Family Medicine	Primary care clinicians providing office-based OUD treatment and longitudinal care.
`106H00000X`	Behavioral Health Counselor	Licensed counselors delivering individual and group therapy and counseling.
`334200000X`	Case Management	Case managers providing care coordination and community resource linkage.

ICD-10 Code	Description	Clinical Relevance
`F11.20`	Opioid dependence, uncomplicated	Core diagnosis for office-based medication-assisted treatment and ongoing counseling billed under `G2087`.
`F11.21`	Opioid dependence, in remission	Relevant for follow-up visits focused on relapse prevention and continued counseling.
`F11.23`	Opioid dependence with withdrawal	Indicates active withdrawal management needs during treatment visits.
`F11.10`	Opioid abuse, uncomplicated	May be used if criteria align with abuse rather than dependence in clinical documentation.
`Z71.51`	Drug abuse counseling and surveillance of drug therapy	Documents provision of counseling and monitoring integral to `G2087` services.

CPT Code	Description	Relationship to This Procedure
`99407`	Tobacco and/or nicotine cessation counseling, intensive (greater than 10 minutes)	May be delivered as an adjunct behavioral counseling service during OUD treatment visits.
`99408`	Alcohol and/or substance abuse structured screening and brief intervention services (15–30 minutes)	Used for SBIRT activities that precede or complement ongoing OUD treatment and counseling.
`90832`	Psychotherapy, 30 minutes with patient	Individual psychotherapy sessions commonly provided as part of the counseling component of `G2087`.
`90834`	Psychotherapy, 45 minutes with patient	Common duration code for individual therapy that may be aggregated with other counseling to meet the 60-minute monthly threshold.
`99406`	Smoking and tobacco use cessation counseling visit, intermediate (3–10 minutes)	Short counseling that can be part of comprehensive behavioral care in OUD management.
`99078`	Physician educational or training services rendered to the patient (not commonly used)	Occasionally used for structured education sessions specific to OUD management; check payer policy before use.

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