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US · guidance

CMS Pub. 100-04, ch. 18, § 180.3

Professional Billing Requirements

activein force · 2026-08-25 – presentas-observed

For claims with dates of service on and after October 14, 2011, CMS will allow coverage for

annual alcohol misuse screening, 15 minutes, G0442, and behavioral counseling for alcohol

misuse, 15 minutes, G0443, only when services are submitted by the following provider

specialties found on the provider’s enrollment record:

01 - General Practice

08 - Family Practice

11 - Internal Medicine

16 - Obstetrics/Gynecology

37 - Pediatric Medicine

38 - Geriatric Medicine

42 - Certified Nurse-Midwife

50 - Nurse Practitioner

89 - Certified Clinical Nurse Specialist

97 - Physician Assistant

Any claims that are not submitted from one of the provider specialty types noted above will be

denied.

For claims with dates of service on and after October 14, 2011, CMS will allow coverage for

annual alcohol misuse screening, 15 minutes, G0442, and behavioral counseling for alcohol

misuse, 15 minutes, G0443, only when submitted with one of the following place of service

(POS) codes:

11 - Physician’s Office

22 - Outpatient Hospital

49 - Independent Clinic

71 - State or local public health clinic or

Any claims that are not submitted with one of the POS codes noted above will be denied.

The alcohol screening/counseling services are payable with another encounter/visit on the same

day. This does not apply for IPPE.

History

(Rev. 2433, Issued: 03-26-12, Effective: 10-14-11, Implementation: 12-27-11 non-system changes, 04-02-12 shared system changes, 07-02-12 CWF/HICR/MCS MCSDT)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
c76ef70e8d6955216debeacc662159674020b43776c569fbe7e5aab7d8125d7e
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