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HCPCS G2078 · Level II · G code

G2078: Take-home supply of methadone, HCPCS Level II G code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); PFS relative value file: RVU26D, released August 26, 2026 (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026); Medicare Coverage Database LCD export: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; RVU27A with the CY2027 PFS final rule, effective January 1, 2027 for the PFS relative value file; weekly, every Thursday for the Medicare Coverage Database LCD export.

Key facts for G2078

Medicare payment
no PFS amount
PFS status X; OPPS SI A: paid under another fee schedule or system
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
Practitioner MUE
3
MAI 3
OPPS status
SI A
Services not paid under OPPS; paid under fee schedule or other payment system
NCCI PTP pairs
0
practitioner file
LCDs and articles
1 / 1

TL;DR

G2078 is a Level II code from the G section (procedures and professional services, temporary), in use since 2020: "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". The physician fee schedule lists G2078 with status X (statutory exclusion: not a physician service under the fee schedule), so the PFS carries no national amount for it. Its OPPS status indicator is A, which the I/OCE table defines as "Services not paid under OPPS; paid under fee schedule or other payment system": Medicare pays G2078 under a fee schedule or payment system other than OPPS. Its 2026 Q4 MUEs per date of service: practitioner 3 (MAI 3, CMS Policy); hospital outpatient 3 (MAI 3, CMS Policy). 1 active LCD and 1 billing and coding article list G2078 across 4 states: L39849 (Opioid Treatment Programs), A59718. HCPCS record: BETOS M5D (specialist - other); pricing indicator 13; type of service 1 (medical care). Nearby codes: G2079, G2076, G2082, G2083.

G2078 descriptor and code status

The October 2026 HCPCS Level II file describes G2078 as “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”. It sits in the G section (procedures and professional services, temporary), listed with the other G codes.

HCPCS file attributes of G2078
FieldValue
Short descriptorTake-home meth
Added to HCPCS2020-01-01
Last actionN (no maintenance), effective 2020-01-01
Coverage codeC: carrier judgment, so the Medicare contractor decides coverage
Pricing indicator13: physician fee schedule, priced by the contractor
BETOS categoryM5D: specialist - other
Type of service1: medical care

Medicare payment for G2078

The physician fee schedule lists G2078 with status X (statutory exclusion: not a physician service under the fee schedule), so the PFS carries no national amount for it. Its OPPS status indicator is A, which the I/OCE table defines as "Services not paid under OPPS; paid under fee schedule or other payment system": Medicare pays G2078 under a fee schedule or payment system other than OPPS. The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.

Physician fee schedule (RVU26D)

Status X: statutory exclusion: not a physician service under the fee schedule. Global period XXX (global surgery concept does not apply); PC/TC indicator 9 (professional/technical concept does not apply).

Hospital outpatient (OPPS Addendum B)

Status indicator A (Services not paid under OPPS; paid under fee schedule or other payment system), with no separate OPPS payment rate.

Medically Unlikely Edits for G2078

Its 2026 Q4 MUEs per date of service: practitioner 3 (MAI 3, CMS Policy); hospital outpatient 3 (MAI 3, CMS Policy). The practitioner MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for G2078 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services33 Date of Service Edit: ClinicalCMS Policy
Facility outpatient hospital33 Date of Service Edit: ClinicalCMS Policy

The MUE lookup for G2078 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists G2078 in v323r0.

G2078 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Pair counts show exposure, not the answer for one claim. Check G2078 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for G2078

1 active Local Coverage Determination and 1 billing and coding article list G2078. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

Billing and Coding Articles listing G2078
ArticleTitleContractor(s)Related LCD
A59718Billing and Coding: Opioid Treatment ProgramsPalmetto GBAL39849

Denials to expect on G2078

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists G2078

CARC 151 · N362

units of G2078 exceed the practitioner MUE of 3 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks the description, invoice or pricing detail a contractor-priced code needs

Where QuickIntell fits for G2078 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for G2078 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.

See QuickCode for coder reviewSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS G2078

What does HCPCS code G2078 describe?

"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"), in the G section (procedures and professional services, temporary). Added 2020-01-01.

Is G2078 a CPT code?

No. G2078 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set.

What does Medicare pay for G2078?

The physician fee schedule lists G2078 with status X (statutory exclusion: not a physician service under the fee schedule), so the PFS carries no national amount for it. Its OPPS status indicator is A, which the I/OCE table defines as "Services not paid under OPPS; paid under fee schedule or other payment system": Medicare pays G2078 under a fee schedule or payment system other than OPPS.

How many units of G2078 can be billed per day?

Its 2026 Q4 MUEs per date of service: practitioner 3 (MAI 3, CMS Policy); hospital outpatient 3 (MAI 3, CMS Policy). For the practitioner MUE (MAI 3), units above 3 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover G2078?

Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 1 active LCD and 1 billing and coding article list G2078 across 4 states: L39849 (Opioid Treatment Programs), A59718.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.