G040 – Drugs of abuse screen, urine

Payment rules:

1. For the purposes of opioid agonist maintenance treatment, G040, G042, G041 and G043 are only eligible for payment to a physician who has an active general exemption for methadone maintenance treatment or chronic pain treatment with methadone pursuant to Section 56 of the Controlled Drugs and Substances Act 1996.

2. G040 and G041 are limited to a maximum of five (5) services per patient (any combination) per month to any physician when K682 or K683 is payable.

3. G042 and G043 are limited to a maximum of four (4) services per patient (any combination) per month to any physician when K682 or K683 is payable.

4. Any combination of G040, G041, G042 and G043 is limited to a maximum of three (3) services per patient per month for management of a patient with chronic pain, an addiction, or receiving opioid agonist treatment program where K682 or K683 is not payable in the month for the same patient to any physician.

5. G040, G041, G042 and G043 are not eligible for payment unless K623 or K624 or a consultation, assessment or time-based service involving a direct physical encounter with the patient is payable in the same month to the same physician rendering the G040, G041, G042 or G043 service.

8. Only one of G040, G041, G042 or G043 is eligible for payment per urine sample.