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G2172

G2172All inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project

HCPCSActiveBETOS Z2

G2172 is a HCPCS Level II code for all inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project. It belongs to the Procedures and Professional Services (Temporary) section. Whether Medicare pays it depends on the coverage rule below.

Medicare coverage: Carrier judgment

Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.

From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.

Physician fee schedule statusX

Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.

Global period: XXX

Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.

Medically Unlikely Edits — units per day

The most units of G2172 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.

practitioner
1 unit
MAI 3 — Date of Service Edit: Clinical · Nature of Service/Procedure
outpatient
1 unit
MAI 3 — Date of Service Edit: Clinical · Nature of Service/Procedure

The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.

The CMS record for G2172

Long descriptor
All inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project

The official wording. This is what the code means.

Short descriptor
Tx for opioid use demo proj

CMS's 28-character form, which is what shows up on a remittance advice.

Added
April 1, 2021

When CMS introduced the code.

BETOS
Z2

Berenson-Eggers Type of Service — CMS's own analytic grouping.

Pricing indicator
00 — Not priced by Part B

Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.

Codes adjacent to G2172

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G2172 is not quite right, the correct code is very often within a few positions of it.

  • G2164Patient had a prior influenza virus vaccine adverse reaction any time before or during the measurement periodterminated
  • G2165Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period; or did not have a prior influenza virus vaccine adverse reaction any time before or during the measurement periodterminated
  • G2166Patient refused to participate at admission and/or discharge; patient unable to complete the neck fs prom at admission or discharge due to cognitive deficit, visual deficit, motor deficit, language barrier, or low reading level, and a suitable proxy/recorder is not available; patient self-discharged early; medical reasonterminated
  • G2167Residual score for the neck impairment successfully calculated and the score was less than zero (< 0)
  • G2168Services performed by a physical therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program, each 15 minutes
  • G2169Services performed by an occupational therapist assistant in the home health setting in the delivery of a safe and effective occupational therapy maintenance program, each 15 minutes
  • G2170Percutaneous arteriovenous fistula creation (avf), direct, any site, by tissue approximation using thermal resistance energy, and secondary procedures to redirect blood flow (e.g., transluminal balloon angioplasty, coil embolization) when performed, and includes all imaging and radiologic guidance, supervision and interpretation, when performedterminated
  • G2171Percutaneous arteriovenous fistula creation (avf), direct, any site, using magnetic-guided arterial and venous catheters and radiofrequency energy, including flow-directing procedures (e.g., vascular coil embolization with radiologic supervision and interpretation, wen performed) and fistulogram(s), angiography, enography, and/or ultrasound, with radiologic supervision and interpretation, when performedterminated
  • G2173Uri episodes where the patient had a comorbid condition during the 12 months prior to or on the episode date (e.g., tuberculosis, neutropenia, cystic fibrosis, chronic bronchitis, pulmonary edema, respiratory failure, rheumatoid lung disease)
  • G2174Uri episodes where the patient is taking antibiotics (table 1) in the 30 days prior to the episode date
  • G2175Episodes where the patient had a comorbid condition during the 12 months prior to or on the episode date (e.g., tuberculosis, neutropenia, cystic fibrosis, chronic bronchitis, pulmonary edema, respiratory failure, rheumatoid lung disease)
  • G2176Outpatient, ed, or observation visits that result in an inpatient admission
  • G2177Acute bronchitis/bronchiolitis episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to the episode date
  • G2178Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure, for example patient bilateral amputee; patient has condition that would not allow them to accurately respond to a neurological exam (dementia, alzheimer's, etc.); patient has previously documented diabetic peripheral neuropathy with loss of protective sensation
  • G2179Clinician documented that patient had medical reason for not performing lower extremity neurological exam
  • G2180Clinician documented that patient was not an eligible candidate for evaluation of footwear as patient is bilateral lower extremity amputee

Questions about G2172

What is HCPCS code G2172?

G2172 is a HCPCS Level II code for all inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project. It sits in the Procedures and Professional Services (Temporary) section.

Does Medicare cover G2172?

The CMS HCPCS file marks G2172 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.

How is G2172 paid under the physician fee schedule?

G2172 carries PFS status code X. Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.

HCPCS Level II2026Q3-Jul· effective July 1, 2026