G2216 HCPCS code: Take-home supply of injectable naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure
G2216 is the HCPCS Level II code for take-home supply of injectable naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case.
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 |
Medicare policy articles for this code
- A59718: Billing and Coding: Opioid Treatment Programs (Palmetto GBA (MAC - Part A, MAC - Part B))
Covered diagnoses (39 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| F11.10 | Opioid abuse, uncomplicated | 1 |
| F11.11 | Opioid abuse, in remission | 1 |
| F11.120 | Opioid abuse with intoxication, uncomplicated | 1 |
| F11.121 | Opioid abuse with intoxication delirium | 1 |
| F11.122 | Opioid abuse with intoxication with perceptual disturbance | 1 |
| F11.13 | Opioid abuse with withdrawal | 1 |
| F11.14 | Opioid abuse with opioid-induced mood disorder | 1 |
| F11.150 | Opioid abuse with opioid-induced psychotic disorder with delusions | 1 |
| F11.151 | Opioid abuse with opioid-induced psychotic disorder with hallucinations | 1 |
| F11.181 | Opioid abuse with opioid-induced sexual dysfunction | 1 |
Showing 10 of 39. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for G2216
- 2021-01-01: G2216 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 G2216?
G2216 is the HCPCS Level II code for take-home supply of injectable naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure. Short descriptor: "Home supply inject naloxon".
Does Medicare cover G2216?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for G2216?
Medicare policy articles that cite G2216 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.
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 G2216
- Watch G2216 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G2216
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.