G2078 HCPCS code: Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure

G2078 is the HCPCS Level II code for take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure. In 2024 Medicare paid an average of $38.63 per service for G2078 across 310,702 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 3 per day on outpatient hospital claims. Medicare volume fell 3% from 2022 to 2024 (321,005 to 310,702 services). In 2024, about 1,064 clinicians billed Medicare for G2078 for 17,576 beneficiaries; California, Maryland, Massachusetts accounted for 31% of services.

Code details

FieldValue
SectionG codes — Procedures and professional services (temporary)
Coverage codeC — Carrier judgment
Pricing indicator13
BETOS categoryM5D
Added2020-01-01
Last action effective2020-01-01

Who bills G2078 (2024)

MeasureValue
Clinicians billing (by place of service)1,064
Medicare beneficiaries17,576
States with claims49
Share of services in top 3 states (California, Maryland, Massachusetts)31%

Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.

Medicare utilization for G2078, 2022–2024

YearServicesBeneficiariesAvg. allowedAvg. paid
2022321,00517,574$36.24$35.57
2023324,16817,346$37.68$37.19
2024310,70217,576$39.19$38.63

States with the most G2078 services (2024)

StateServicesAvg. paid
California42,673$38.81
Maryland33,935$39.16
Massachusetts20,670$38.98
New York19,014$37.31
New Jersey16,298$38.54

NCCI unit limits (MUE)

Claim typeMax units per dayRationale
outpatient hospital claims3CMS Policy
practitioner claims3CMS Policy

Medicare policy articles for this code

Covered diagnoses (39 ICD-10-CM codes)

The diagnoses most often listed as covered in the policy articles above:

ICD-10-CMDiagnosisArticles listing it
F11.10Opioid abuse, uncomplicated1
F11.11Opioid abuse, in remission1
F11.120Opioid abuse with intoxication, uncomplicated1
F11.121Opioid abuse with intoxication delirium1
F11.122Opioid abuse with intoxication with perceptual disturbance1
F11.13Opioid abuse with withdrawal1
F11.14Opioid abuse with opioid-induced mood disorder1
F11.150Opioid abuse with opioid-induced psychotic disorder with delusions1
F11.151Opioid abuse with opioid-induced psychotic disorder with hallucinations1
F11.181Opioid abuse with opioid-induced sexual dysfunction1

Showing 10 of 39. The full list, non-covered diagnoses and CSV export are in Caduvo.

What changed for G2078

Frequently asked questions

What is HCPCS code G2078?

G2078 is the HCPCS Level II code for take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure. Short descriptor: "Take-home meth".

How much does Medicare pay for G2078?

In 2024, the average Medicare payment was $38.63 per service (average allowed $39.19).

Does Medicare cover G2078?

Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.

Which diagnoses support coverage for G2078?

Medicare policy articles that cite G2078 list 39 covered ICD-10-CM diagnosis codes across 1 article. The most cited include F11.10 (Opioid abuse, uncomplicated), F11.11 (Opioid abuse, in remission), F11.120 (Opioid abuse with intoxication, uncomplicated). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.

How many units of G2078 can be billed per day?

3 on outpatient hospital claims; 3 on practitioner claims (NCCI medically unlikely edits).

Related G20 codes

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Next steps

Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.

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