HCPCS G0442: what Medicare pays in 2026
Service defined by CMS CMS description: Annual alcohol screen 15 min
Medicare's 2026 national amount for G0442 is $18.70 when a doctor's office or clinic bills it and $8.02 when a doctor bills it for care in a hospital, ER or surgery center. Across Medicare's 109 payment localities the office amount runs from $16.80 in Arkansas to $24.67 in San Jose-Sunnyvale-Santa Clara (San Benito County), CA.
Medicare amounts for G0442 in 2026
- Doctor's office or clinic, national
- $18.70
- Doctor's bill for hospital or surgery-center care, national
- $8.02
- Hospital outpatient rate, national (APC 5821)
- $38.28
- Hospital outpatient status S
- separately paid procedure
Hospital outpatient rates are national figures before Medicare's wage adjustment, which moves about 60% of the rate up or down with local hospital wages.
What providers charged Medicare for G0442 in 2024
From CMS's national utilization file (the most recent full year published). The charge is the provider's list price, the same kind of figure an uninsured patient is usually billed.
| Setting | Services | Average charge | Medicare allowed | Charge vs allowed |
|---|---|---|---|---|
| In an office or other non-facility setting | 1,002,324 | $40.74 | $18.01 | 2.3× |
| In a facility setting | 8,489 | $35.17 | $8.38 | 4.2× |
How Medicare builds the G0442 amount
Each physician fee schedule amount is three relative value units (RVUs), each multiplied by the locality's cost index, added up and multiplied by the 2026 conversion factor of $33.4009.
- Work RVU
- 0.18
- Practice expense RVU, office
- 0.37
- Practice expense RVU, facility
- 0.05
- Malpractice RVU
- 0.01
G0442 in every Medicare locality
The office amount is lowest in Arkansas and highest in San Jose-Sunnyvale-Santa Clara (San Benito County), CA. The facility amount runs from $7.62 to $10.98.