AHA Coding Clinic® for HCPCS - 2025 Issue 2; In This Issue

Proper assignment of HCPCS Codes G0534-G0536 in Medicare-enrolled opioid treatment programs

The Healthcare Common Procedure Coding System (HCPCS) includes specific codes for services provided by Medicare-enrolled Opioid Treatment Programs (OTPs). HCPCS codes G0534, G0535, and G0536 describe additional services related to coordinated care, patient navigation, and peer recovery support for individuals undergoing treatment for opioid use disorder (OUD). These services help enhance patient care by addressing health-related social needs, improving access to treatment resources, and supporting long-term recovery.This article provides guidance on how to properly assign these HCPCS codes, including service eligibility and documentation expectations.HCPCS Code G0534 — Coordinated care and referral servicesDEFINITION:G0534 covers coordinated care and/or referral...

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