99406

Smoking and tobacco use intensive counseling, 4-10 minutes

Medicare pricing data for 48,402 providers across 52 states

🤖AI Overview

Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Smoking and tobacco use intensive counseling, 4-10 minutes (HCPCS code 99406) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $13.46, but hospitals typically charge $37.22 — a 2.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.69

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $13.46, your out-of-pocket cost would be approximately $2.69. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$13.46
Average Hospital Charge
$37.22
Markup Ratio
2.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$37.22
Medicare Allowed$13.46
Medicare Payment$13.46

Hospitals charge 2.8x more than what Medicare allows for this procedure. Medicare actually pays $13.46 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$17$6257219+22.6%
New Jersey$15$411,56511,517+13.3%
New York$15$494,07328,143+12.8%
Hawaii$15$3072319+9.7%
California$15$462,71922,773+9.6%
Connecticut$15$395652,659+8.8%
Puerto Rico$15$401136+8.1%
Maryland$14$349628,731+6.7%
District of Columbia$14$37128817+4.2%
Delaware$14$321741,515+4.1%
Florida$14$383,35123,370+3.3%
Massachusetts$14$421,63212,557+3.2%
Pennsylvania$14$361,6069,879+3.1%
Michigan$14$312,28218,757+1.1%
Illinois$14$391,65712,990+1.0%
Wyoming$14$3442209+0.8%
Georgia$13$381,76712,885-0.3%
Colorado$13$336682,638-0.4%
Washington$13$391,0114,251-1.1%
Arizona$13$348404,669-1.4%
Rhode Island$13$52100513-2.1%
South Carolina$13$351,0676,601-2.7%
Oregon$13$405932,542-3.0%
Texas$13$352,86618,692-3.6%
Alabama$13$258457,322-4.5%
North Carolina$13$362,45620,255-4.8%
Louisiana$13$338255,487-5.2%
Nevada$13$454514,177-5.4%
Kansas$13$334142,062-5.5%
New Hampshire$13$462951,218-5.6%
Kentucky$13$331,0078,107-5.8%
Indiana$13$331,2117,681-6.4%
Virginia$13$301,2708,075-6.5%
New Mexico$13$332561,237-6.7%
Utah$13$51117446-6.8%
Vermont$13$3763287-6.8%
Wisconsin$13$465742,313-6.8%
Oklahoma$13$318978,991-7.0%
Tennessee$12$331,78412,159-7.3%
Ohio$12$332,06412,630-7.4%
Arkansas$12$295495,923-7.7%
Nebraska$12$342761,419-8.1%
Minnesota$12$435691,685-9.1%
Mississippi$12$386507,196-9.3%
Montana$12$28187821-9.4%
West Virginia$12$362771,486-9.5%
North Dakota$12$3283342-10.2%
South Dakota$12$3269331-10.9%
Idaho$12$33140691-11.0%
Iowa$12$38276958-11.7%
Missouri$12$347665,954-12.0%
Maine$11$371911,074-19.4%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber