How much does Medicare pay for HCPCS G2011?

Medicare allowed an average of $15.58 per service and paid $11.33 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $43.22, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code G2011?

Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention, 5-14 minutes. It was billed 9,604 times to 8,513 Medicare beneficiaries by 108 providers in 2024.

Which specialty bills G2011 most?

Family Practice, with 2,183 services from 17 clinicians. Next are Internal Medicine, Anesthesiology, Nurse Practitioner.

HCPCS G2011

Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention, 5-14 minutes

$15.58Medicare-allowed amount per service, averaged across 9,604 services

Providers submitted

$43.22

Asking price, not received

Medicare allowed

$15.58

The fee schedule figure

Medicare paid

$11.33

Balance is patient coinsurance

Providers submitted an average of $43.22 for this code and Medicare allowed $15.58 — 2.8× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $11.33 (73%); the rest is the patient’s coinsurance and deductible.

Services: 9,604
Beneficiaries: 8,513
Providers billing it: 108
Total allowed: $149,630

What Medicare pays for HCPCS G2011

Across 9,604 services billed by 108 providers to 8,513 beneficiaries, Medicare allowed an average of $15.58 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills G2011

Specialty	Services	Beneficiaries	Avg allowed	Providers
Family Practice	2,183	1,853	$16.42	17
Internal Medicine	1,412	1,398	$16.66	25
Anesthesiology	1,258	1,140	$15.80	7
Nurse Practitioner	1,127	1,031	$13.28	15
Pain Management	1,069	946	$15.49	5
Interventional Pain Management	551	342	$15.15	6
Physician Assistant	529	463	$13.44	10
Orthopedic Surgery	260	248	$15.98	2
Nephrology	241	194	$15.44	2
Infectious Disease	226	195	$15.70	6
Rheumatology	207	179	$16.14	1
Psychologist, Clinical	159	155	$16.99	1
Diagnostic Radiology	129	129	$15.53	1
Physical Medicine and Rehabilitation	75	71	$17.56	3
General Practice	65	62	$15.52	2

G2011 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Oklahoma	2,457	$14.28	$11.27	12
Maryland	1,779	$17.22	$10.56	21
Texas	1,490	$15.62	$12.53	13
Delaware	583	$16.67	$12.43	5
Tennessee	573	$14.71	$12.30	4
Louisiana	568	$15.53	$12.55	2
California	511	$17.28	$12.48	3
Georgia	509	$14.95	$10.98	15
Florida	371	$15.62	$11.54	9
Maine	182	$15.61	$10.56	2
South Carolina	98	$14.06	$9.73	3
Michigan	98	$15.34	$11.49	3
New York	89	$18.84	$12.71	2
Mississippi	71	$5.89	$4.97	1
New Jersey	64	$17.79	$13.04	2
Ohio	45	$13.57	$11.72	3
Massachusetts	45	$17.20	$11.33	3
Virginia	18	$15.16	$13.05	1
North Carolina	16	$13.35	$11.09	1
Pennsylvania	13	$15.87	$12.97	1
Illinois	12	$16.55	$12.86	1
Oregon	12	$14.20	$10.17	1

Related codes

G2067Medication assisted treatment$225.81
G2078Take-home supply of methadone; up to 7 additional day supply (provisio$39.17
G2012Brief communication technology-based service$13.77
G2077Periodic assessment; assessing periodically by qualified personnel to$121.19
G2074Medication assisted treatment$204.11
G2083Office or other outpatient visit for the evaluation and management of$1215.85
G2087Office-based treatment for opioid use disorder$367.01
G2068Medication assisted treatment$281.73
G2080Each additional 30 minutes of counseling in a week of medication assis$35.16
G2088Office-based treatment for opioid use disorder$49.83
G2076Intake activities$195.81
G2010Remote evaluation of recorded video and/or images submitted by an esta$11.93

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.