G2213 HCPCS code: Initiation of medication for the treatment of opioid use disorder in the emergency department setting, including assessment, referral to ongoing care, and arranging access to supportive services (list separately in addition to code for primary procedure)
G2213 is the HCPCS Level II code for initiation of medication for the treatment of opioid use disorder in the emergency department setting, including assessment, referral to ongoing care, and arranging access to supportive services (list separately in addition to code for primary procedure). In 2024 Medicare paid an average of $44.09 per service for G2213 across 254 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 1 per day on outpatient hospital claims. Medicare volume rose 50% from 2022 to 2024 (169 to 254 services). In 2024, about 226 clinicians billed Medicare for G2213 for 228 beneficiaries; California, Massachusetts, Florida accounted for 82% of services.
Code details
| Field | Value |
|---|---|
| Section | G codes — Procedures and professional services (temporary) |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 11 — Priced using national relative value units (Physician Fee Schedule) |
| BETOS category | Z2 |
| Added | 2021-01-01 |
| Last action effective | 2021-01-01 |
Who bills G2213 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 226 |
| Medicare beneficiaries | 228 |
| States with claims | 5 |
| Share of services in top 3 states (California, Massachusetts, Florida) | 82% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for G2213, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 169 | 153 | $64.52 | $48.87 |
| 2023 | 166 | 151 | $60.49 | $46.99 |
| 2024 | 254 | 228 | $58.65 | $44.09 |
States with the most G2213 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 57 | $43.37 |
| Massachusetts | 30 | $45.09 |
| Florida | 17 | $46.99 |
| New Jersey | 12 | $49.95 |
| Michigan | 11 | $47.73 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Code Descriptor / CPT Instruction |
| practitioner claims | 1 | Code Descriptor / CPT Instruction |
What changed for G2213
- 2021-01-01: G2213 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code G2213?
G2213 is the HCPCS Level II code for initiation of medication for the treatment of opioid use disorder in the emergency department setting, including assessment, referral to ongoing care, and arranging access to supportive services (list separately in addition to code for primary procedure). Short descriptor: "Initiat med assist tx in er".
How much does Medicare pay for G2213?
In 2024, the average Medicare payment was $44.09 per service (average allowed $58.65).
Does Medicare cover G2213?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of G2213 can be billed per day?
1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
Related G22 codes
- G2200 — Patient identified as an unhealthy alcohol user received brief counseling
- G2201 — Documentation of medical reason(s) for not providing brief counseling (e.g., limited life expectancy, other medical reasons)
- G2202 — Patient did not receive brief counseling if identified as an unhealthy alcohol user
- G2203 — Documentation of medical reason(s) for not providing brief counseling if identified as an unhealthy alcohol user (e.g., limited life expectancy, other medical reasons)
- G2204 — Patients between 45 and 85 years of age who received a screening colonoscopy during the performance period
- G2205 — Patients with pregnancy during adjuvant treatment course
- G2206 — Patient received adjuvant treatment course including both chemotherapy and her2-targeted therapy
- G2207 — Reason for not administering adjuvant treatment course including both chemotherapy and her2-targeted therapy (e.g. poor performance status (ecog 3-4; karnofsky <=50), cardiac contraindications, insufficient renal function, insufficient hepatic function, other active or secondary cancer diagnoses, other medical contraindications, patients who died during initial treatment course or transferred during or after initial treatment course)
- G2208 — Patient did not receive adjuvant treatment course including both chemotherapy and her2-targeted therapy
- G2209 — Patient refused to participate
- G2210 — Residual score for the neck impairment not measured because the patient did not complete the neck fs prom at initial evaluation and/or near discharge, reason not given
- G2211 — Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to home or residence or office/outpatient evaluation and management service, new or established)
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Next steps
- Run a reimbursement report for a device billed under G2213
- Watch G2213 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G2213
Sources: CMS HCPCS Level II release October 2026; 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.