99407

Smoking and tobacco use intensive counseling, more than 10 minutes

Medicare pricing data for 8,878 providers across 50 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, more than 10 minutes (HCPCS code 99407) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $26.27, but hospitals typically charge $64.21 — a 2.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$5.25

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $26.27, your out-of-pocket cost would be approximately $5.25. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$26.27
Average Hospital Charge
$64.21
Markup Ratio
2.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$64.21
Medicare Allowed$26.27
Medicare Payment$26.27

Hospitals charge 2.4x more than what Medicare allows for this procedure. Medicare actually pays $26.27 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$30$787904,738+12.8%
Vermont$29$74525+11.6%
District of Columbia$29$5029221+11.3%
New Jersey$29$853832,069+8.7%
Hawaii$28$58818+4.7%
Maryland$27$601871,640+4.3%
Connecticut$27$65114511+3.5%
Rhode Island$27$5732221+3.5%
California$27$5979714,967+3.4%
Illinois$27$563332,323+2.7%
Massachusetts$27$862931,848+2.4%
Delaware$27$43856+2.2%
Michigan$27$493012,057+2.1%
Wyoming$27$541126+1.9%
Florida$27$647635,219+1.3%
Colorado$26$62101292+0.5%
Pennsylvania$26$593331,393-1.8%
Washington$26$73165488-2.9%
Georgia$25$652761,254-3.3%
Missouri$25$5594351-3.3%
Texas$25$605965,140-3.8%
Louisiana$25$641571,279-4.5%
Oregon$25$84120309-5.0%
North Carolina$25$673641,998-5.1%
Minnesota$25$98131432-6.0%
Ohio$24$76275905-6.9%
Tennessee$24$67240801-7.0%
South Carolina$24$59145590-7.1%
Kentucky$24$64158877-7.2%
Arizona$24$78161910-7.6%
Oklahoma$24$62114740-7.8%
Alabama$24$42112614-8.0%
West Virginia$24$5237250-8.2%
New Hampshire$24$7750211-8.3%
North Dakota$24$731227-8.8%
New Mexico$24$673281-8.9%
Nevada$24$541191,704-9.2%
Wisconsin$24$9199390-9.2%
Kansas$24$6473204-9.6%
Indiana$24$602151,458-10.3%
Mississippi$24$7396670-10.5%
Arkansas$23$5071299-10.7%
Iowa$23$7353129-10.9%
South Dakota$23$491229-11.1%
Idaho$23$622853-11.7%
Nebraska$23$6359186-12.0%
Utah$23$8439114-13.5%
Montana$22$4939120-15.1%
Maine$22$8128112-16.1%
Virginia$22$49175839-17.0%

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

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