Is G2086 covered for telehealth? (Medicare)
G2086 is a HCPCS code on Medicare's telehealth services list, covering office-based treatment for opioid use disorder that includes 70 minutes of care during the first month. Because it appears on this list, Medicare may reimburse it when furnished via telehealth under the applicable rules, subject to the place-of-service and modifier requirements shown above.
How to bill it
Bill G2086 with the place-of-service code that matches where the patient received the service, either 02 or 10 as listed, and append modifier 95 to indicate the service was delivered via telehealth. Confirm your claim's POS and modifier combination aligns with current MAC and payer edits before submission. POS reference → · modifier reference →
Audio-only
Medicare's list of telehealth services doesn't specify audio-only eligibility for this code. Audio-only is permitted for a number of services (notably behavioral and mental-health care); confirm against current CMS guidance and your payer before billing audio-only.
Frequently asked
Does POS 02 vs POS 10 change payment for G2086?
POS 02 (telehealth provided other than in patient's home) and POS 10 (telehealth provided in patient's home) can affect the payment rate depending on the fee schedule Medicare applies; check current MPFS locality rates for each POS before billing.
Will commercial or Medicaid plans cover G2086 the same way as Medicare?
Not necessarily. This reference reflects Medicare's telehealth list only — commercial payers and state Medicaid programs have their own telehealth policies, POS rules, and modifier requirements that must be verified separately.
Is modifier 95 always required with G2086?
Modifier 95 is the guidance shown for this code when billed as telehealth, but billers should confirm current MAC instructions, since modifier requirements can be updated and may differ by payer or claim type.
More free billing tools: all telehealth codes · telehealth checker · Medicare fee for G2086 · place of service · modifiers
Reflects Medicare's list of telehealth services for this year; audio-only, POS and modifier rules can change. Commercial and Medicaid telehealth coverage differ — verify current CMS guidance and your payer's rules before billing.
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