About this policy
The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for Opioid Treatment Programs L39849. This billing and coding article addresses opioid treatment programs (OTP) providing treatment of opiate use disorder (OUD) in non-residential opioid treatment facilities (place of service code 58) that provide treatment on an ambulatory basis.
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
| Code | Code system | Status in this policy |
|---|---|---|
| G0137 | HCPCS | Covered |
| G0532 | HCPCS | Covered |
| G0533 | HCPCS | Covered |
| G0534 | HCPCS | Covered |
| G0535 | HCPCS | Covered |
| G0536 | HCPCS | Covered |
| G1028 | HCPCS | Covered |
| G2067 | HCPCS | Covered |
| G2068 | HCPCS | Covered |
| G2069 | HCPCS | Covered |
| G2073 | HCPCS | Covered |
| G2074 | HCPCS | Covered |
| G2075 | HCPCS | Covered |
| G2076 | HCPCS | Covered |
| G2077 | HCPCS | Covered |
| G2078 | HCPCS | Covered |
| G2079 | HCPCS | Covered |
| G2080 | HCPCS | Covered |
| G2215 | HCPCS | Covered |
| G2216 | HCPCS | Covered |
| F10.10 | ICD10CM | Not covered |
| F10.11 | ICD10CM | Not covered |
| F10.120 | ICD10CM | Not covered |
| F10.121 | ICD10CM | Not covered |
| F10.129 | ICD10CM | Not covered |
| F10.130 | ICD10CM | Not covered |
| F10.131 | ICD10CM | Not covered |
| F10.20 | ICD10CM | Not covered |
| F10.21 | ICD10CM | Not covered |
| F10.220 | ICD10CM | Not covered |
| F10.221 | ICD10CM | Not covered |
| F10.229 | ICD10CM | Not covered |
| F10.230 | ICD10CM | Not covered |
| F10.231 | ICD10CM | Not covered |
| F10.232 | ICD10CM | Not covered |
| F10.239 | ICD10CM | Not covered |
| F10.24 | ICD10CM | Not covered |
| F10.250 | ICD10CM | Not covered |
| F10.251 | ICD10CM | Not covered |
| F10.259 | ICD10CM | Not covered |
| F10.26 | ICD10CM | Not covered |
| F10.27 | ICD10CM | Not covered |
| F10.280 | ICD10CM | Not covered |
| F10.281 | ICD10CM | Not covered |
| F10.282 | ICD10CM | Not covered |
| F10.288 | ICD10CM | Not covered |
| F10.29 | ICD10CM | Not covered |
| F10.90 | ICD10CM | Not covered |
| F10.91 | ICD10CM | Not covered |
| F10.920 | ICD10CM | Not covered |
| F10.921 | ICD10CM | Not covered |
| F10.929 | ICD10CM | Not covered |
| F10.930 | ICD10CM | Not covered |
| F10.931 | ICD10CM | Not covered |
| F10.932 | ICD10CM | Not covered |
| F10.939 | ICD10CM | Not covered |
| F10.94 | ICD10CM | Not covered |
| F10.950 | ICD10CM | Not covered |
| F10.951 | ICD10CM | Not covered |
| F10.959 | ICD10CM | Not covered |
| F10.96 | ICD10CM | Not covered |
| F10.97 | ICD10CM | Not covered |
| F10.980 | ICD10CM | Not covered |
| F10.981 | ICD10CM | Not covered |
| F10.982 | ICD10CM | Not covered |
| F10.988 | ICD10CM | Not covered |
| F10.99 | ICD10CM | Not covered |
| F11.10 | ICD10CM | Covered |
| F11.11 | ICD10CM | Covered |
| F11.120 | ICD10CM | Covered |
| F11.121 | ICD10CM | Covered |
| F11.122 | ICD10CM | Covered |
| F11.13 | ICD10CM | Covered |
| F11.14 | ICD10CM | Covered |
| F11.150 | ICD10CM | Covered |
| F11.151 | ICD10CM | Covered |
| F11.181 | ICD10CM | Covered |
| F11.182 | ICD10CM | Covered |
| F11.188 | ICD10CM | Covered |
| F11.19 | ICD10CM | Covered |
| F11.20 | ICD10CM | Covered |
| F11.21 | ICD10CM | Covered |
| F11.220 | ICD10CM | Covered |
| F11.221 | ICD10CM | Covered |
| F11.222 | ICD10CM | Covered |
| F11.23 | ICD10CM | Covered |
| F11.24 | ICD10CM | Covered |
| F11.250 | ICD10CM | Covered |
| F11.251 | ICD10CM | Covered |
| F11.281 | ICD10CM | Covered |
| F11.282 | ICD10CM | Covered |
| F11.288 | ICD10CM | Covered |
| F11.29 | ICD10CM | Covered |
| F11.90 | ICD10CM | Covered |
| F11.91 | ICD10CM | Covered |
| F11.920 | ICD10CM | Covered |
| F11.921 | ICD10CM | Covered |
| F11.922 | ICD10CM | Covered |
| F11.93 | ICD10CM | Covered |
| F11.94 | ICD10CM | Covered |
| F11.950 | ICD10CM | Covered |
| F11.951 | ICD10CM | Covered |
| F11.981 | ICD10CM | Covered |
| F11.982 | ICD10CM | Covered |
| F11.988 | ICD10CM | Covered |
| F11.99 | ICD10CM | Covered |
| F12.10 | ICD10CM | Not covered |
| F12.11 | ICD10CM | Not covered |
| F12.120 | ICD10CM | Not covered |
| F12.121 | ICD10CM | Not covered |
| F12.122 | ICD10CM | Not covered |
| F12.129 | ICD10CM | Not covered |
| F12.13 | ICD10CM | Not covered |
| F12.150 | ICD10CM | Not covered |
| F12.151 | ICD10CM | Not covered |
| F12.159 | ICD10CM | Not covered |
| F12.180 | ICD10CM | Not covered |
| F12.188 | ICD10CM | Not covered |
| F12.19 | ICD10CM | Not covered |
| F12.20 | ICD10CM | Not covered |
| F12.21 | ICD10CM | Not covered |
| F12.220 | ICD10CM | Not covered |
| F12.221 | ICD10CM | Not covered |
| F12.222 | ICD10CM | Not covered |
| F12.229 | ICD10CM | Not covered |
| F12.23 | ICD10CM | Not covered |
| F12.250 | ICD10CM | Not covered |
| F12.251 | ICD10CM | Not covered |
| F12.259 | ICD10CM | Not covered |
| F12.280 | ICD10CM | Not covered |
| F12.288 | ICD10CM | Not covered |
| F12.29 | ICD10CM | Not covered |
| F12.90 | ICD10CM | Not covered |
| F12.91 | ICD10CM | Not covered |
| F12.920 | ICD10CM | Not covered |
| F12.921 | ICD10CM | Not covered |
| F12.922 | ICD10CM | Not covered |
| F12.929 | ICD10CM | Not covered |
| F12.93 | ICD10CM | Not covered |
| F12.950 | ICD10CM | Not covered |
| F12.951 | ICD10CM | Not covered |
| F12.959 | ICD10CM | Not covered |
| F12.980 | ICD10CM | Not covered |
| F12.988 | ICD10CM | Not covered |
| F12.99 | ICD10CM | Not covered |
| F13.10 | ICD10CM | Not covered |
| F13.11 | ICD10CM | Not covered |
| F13.120 | ICD10CM | Not covered |
| F13.121 | ICD10CM | Not covered |
| F13.129 | ICD10CM | Not covered |
| F13.130 | ICD10CM | Not covered |
| F13.131 | ICD10CM | Not covered |
| F13.132 | ICD10CM | Not covered |
| F13.139 | ICD10CM | Not covered |
| F13.14 | ICD10CM | Not covered |
| F13.150 | ICD10CM | Not covered |
| F13.151 | ICD10CM | Not covered |
| F13.159 | ICD10CM | Not covered |
| F13.180 | ICD10CM | Not covered |
| F13.181 | ICD10CM | Not covered |
| F13.182 | ICD10CM | Not covered |
| F13.188 | ICD10CM | Not covered |
| F13.19 | ICD10CM | Not covered |
| F13.20 | ICD10CM | Not covered |
| F13.21 | ICD10CM | Not covered |
| F13.220 | ICD10CM | Not covered |
| F13.221 | ICD10CM | Not covered |
| F13.229 | ICD10CM | Not covered |
| F13.230 | ICD10CM | Not covered |
| F13.231 | ICD10CM | Not covered |
| F13.232 | ICD10CM | Not covered |
| F13.239 | ICD10CM | Not covered |
| F13.24 | ICD10CM | Not covered |
| F13.250 | ICD10CM | Not covered |
| F13.251 | ICD10CM | Not covered |
| F13.259 | ICD10CM | Not covered |
| F13.26 | ICD10CM | Not covered |
| F13.27 | ICD10CM | Not covered |
| F13.280 | ICD10CM | Not covered |
| F13.281 | ICD10CM | Not covered |
| F13.282 | ICD10CM | Not covered |
| F13.288 | ICD10CM | Not covered |
| F13.29 | ICD10CM | Not covered |
| F13.90 | ICD10CM | Not covered |
| F13.91 | ICD10CM | Not covered |
| F13.920 | ICD10CM | Not covered |
| F13.921 | ICD10CM | Not covered |
| F13.929 | ICD10CM | Not covered |
| F13.930 | ICD10CM | Not covered |
| F13.931 | ICD10CM | Not covered |
| F13.932 | ICD10CM | Not covered |
| F13.939 | ICD10CM | Not covered |
| F13.94 | ICD10CM | Not covered |
| F13.950 | ICD10CM | Not covered |
| F13.951 | ICD10CM | Not covered |
| F13.959 | ICD10CM | Not covered |
| F13.96 | ICD10CM | Not covered |
| F13.97 | ICD10CM | Not covered |
| F13.980 | ICD10CM | Not covered |
| F13.981 | ICD10CM | Not covered |
| F13.982 | ICD10CM | Not covered |
| F13.988 | ICD10CM | Not covered |
| F13.99 | ICD10CM | Not covered |
| F14.10 | ICD10CM | Not covered |
| F14.11 | ICD10CM | Not covered |
| F14.120 | ICD10CM | Not covered |
| F14.122 | ICD10CM | Not covered |
| F14.129 | ICD10CM | Not covered |
| F14.13 | ICD10CM | Not covered |
| F14.14 | ICD10CM | Not covered |
| F14.150 | ICD10CM | Not covered |
| F14.151 | ICD10CM | Not covered |
| F14.159 | ICD10CM | Not covered |
| F14.180 | ICD10CM | Not covered |
| F14.181 | ICD10CM | Not covered |
| F14.182 | ICD10CM | Not covered |
| F14.188 | ICD10CM | Not covered |
| F14.19 | ICD10CM | Not covered |
| F14.20 | ICD10CM | Not covered |
| F14.21 | ICD10CM | Not covered |
| F14.220 | ICD10CM | Not covered |
| F14.221 | ICD10CM | Not covered |
| F14.222 | ICD10CM | Not covered |
| F14.229 | ICD10CM | Not covered |
| F14.23 | ICD10CM | Not covered |
| F14.24 | ICD10CM | Not covered |
| F14.250 | ICD10CM | Not covered |
| F14.251 | ICD10CM | Not covered |
| F14.259 | ICD10CM | Not covered |
| F14.280 | ICD10CM | Not covered |
| F14.281 | ICD10CM | Not covered |
| F14.282 | ICD10CM | Not covered |
| F14.288 | ICD10CM | Not covered |
| F14.29 | ICD10CM | Not covered |
| F14.90 | ICD10CM | Not covered |
| F14.91 | ICD10CM | Not covered |
| F14.920 | ICD10CM | Not covered |
| F14.921 | ICD10CM | Not covered |
| F14.922 | ICD10CM | Not covered |
| F14.929 | ICD10CM | Not covered |
| F14.93 | ICD10CM | Not covered |
| F14.94 | ICD10CM | Not covered |
| F14.950 | ICD10CM | Not covered |
| F14.951 | ICD10CM | Not covered |
| F14.959 | ICD10CM | Not covered |
| F14.980 | ICD10CM | Not covered |
| F14.981 | ICD10CM | Not covered |
| F14.982 | ICD10CM | Not covered |
| F14.988 | ICD10CM | Not covered |
| F14.99 | ICD10CM | Not covered |
| F15.10 | ICD10CM | Not covered |
| F15.11 | ICD10CM | Not covered |
| F15.120 | ICD10CM | Not covered |
| F15.121 | ICD10CM | Not covered |
| F15.122 | ICD10CM | Not covered |
| F15.129 | ICD10CM | Not covered |
| F15.13 | ICD10CM | Not covered |
| F15.14 | ICD10CM | Not covered |
| F15.150 | ICD10CM | Not covered |
| F15.151 | ICD10CM | Not covered |
| F15.159 | ICD10CM | Not covered |
| F15.180 | ICD10CM | Not covered |
| F15.181 | ICD10CM | Not covered |
| F15.182 | ICD10CM | Not covered |
| F15.188 | ICD10CM | Not covered |
| F15.19 | ICD10CM | Not covered |
| F15.20 | ICD10CM | Not covered |
| F15.21 | ICD10CM | Not covered |
| F15.220 | ICD10CM | Not covered |
| F15.221 | ICD10CM | Not covered |
| F15.222 | ICD10CM | Not covered |
| F15.229 | ICD10CM | Not covered |
| F15.23 | ICD10CM | Not covered |
| F15.24 | ICD10CM | Not covered |
| F15.250 | ICD10CM | Not covered |
| F15.251 | ICD10CM | Not covered |
| F15.259 | ICD10CM | Not covered |
| F15.280 | ICD10CM | Not covered |
| F15.281 | ICD10CM | Not covered |
| F15.282 | ICD10CM | Not covered |
| F15.288 | ICD10CM | Not covered |
| F15.29 | ICD10CM | Not covered |
| F15.90 | ICD10CM | Not covered |
| F15.91 | ICD10CM | Not covered |
| F15.920 | ICD10CM | Not covered |
| F15.921 | ICD10CM | Not covered |
| F15.922 | ICD10CM | Not covered |
| F15.929 | ICD10CM | Not covered |
| F15.93 | ICD10CM | Not covered |
| F15.94 | ICD10CM | Not covered |
| F15.950 | ICD10CM | Not covered |
| F15.951 | ICD10CM | Not covered |
| F15.959 | ICD10CM | Not covered |
| F15.980 | ICD10CM | Not covered |
| F15.981 | ICD10CM | Not covered |
| F15.982 | ICD10CM | Not covered |
| F15.988 | ICD10CM | Not covered |
| F15.99 | ICD10CM | Not covered |
| F16.10 | ICD10CM | Not covered |
| F16.11 | ICD10CM | Not covered |
| F16.120 | ICD10CM | Not covered |
| F16.121 | ICD10CM | Not covered |
| F16.122 | ICD10CM | Not covered |
| F16.129 | ICD10CM | Not covered |
| F16.14 | ICD10CM | Not covered |
| F16.150 | ICD10CM | Not covered |
| F16.151 | ICD10CM | Not covered |
| F16.159 | ICD10CM | Not covered |
| F16.180 | ICD10CM | Not covered |
| F16.183 | ICD10CM | Not covered |
| F16.188 | ICD10CM | Not covered |
| F16.19 | ICD10CM | Not covered |
| F16.20 | ICD10CM | Not covered |
| F16.21 | ICD10CM | Not covered |
| F16.220 | ICD10CM | Not covered |
| F16.221 | ICD10CM | Not covered |
| F16.229 | ICD10CM | Not covered |
| F16.24 | ICD10CM | Not covered |
| F16.250 | ICD10CM | Not covered |
| F16.251 | ICD10CM | Not covered |
| F16.259 | ICD10CM | Not covered |
| F16.280 | ICD10CM | Not covered |
| F16.283 | ICD10CM | Not covered |
| F16.288 | ICD10CM | Not covered |
| F16.29 | ICD10CM | Not covered |
| F16.90 | ICD10CM | Not covered |
| F16.91 | ICD10CM | Not covered |
| F16.920 | ICD10CM | Not covered |
| F16.921 | ICD10CM | Not covered |
| F16.929 | ICD10CM | Not covered |
| F16.94 | ICD10CM | Not covered |
| F16.950 | ICD10CM | Not covered |
| F16.951 | ICD10CM | Not covered |
| F16.959 | ICD10CM | Not covered |
| F16.980 | ICD10CM | Not covered |
| F16.983 | ICD10CM | Not covered |
| F16.988 | ICD10CM | Not covered |
| F16.99 | ICD10CM | Not covered |
| F17.200 | ICD10CM | Not covered |
| F17.201 | ICD10CM | Not covered |
| F17.203 | ICD10CM | Not covered |
| F17.208 | ICD10CM | Not covered |
| F17.209 | ICD10CM | Not covered |
| F17.210 | ICD10CM | Not covered |
| F17.211 | ICD10CM | Not covered |
| F17.213 | ICD10CM | Not covered |
| F17.218 | ICD10CM | Not covered |
| F17.219 | ICD10CM | Not covered |
| F17.220 | ICD10CM | Not covered |
| F17.221 | ICD10CM | Not covered |
| F17.223 | ICD10CM | Not covered |
| F17.228 | ICD10CM | Not covered |
| F17.229 | ICD10CM | Not covered |
| F17.290 | ICD10CM | Not covered |
| F17.291 | ICD10CM | Not covered |
| F17.293 | ICD10CM | Not covered |
| F17.298 | ICD10CM | Not covered |
| F17.299 | ICD10CM | Not covered |