Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention, 5-14 minutes
Medicare pricing data for 242 providers across 20 states
This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention, 5-14 minutes (HCPCS code G2011) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $15.12, but hospitals typically charge $40.14 — a 2.7x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $15.12, your out-of-pocket cost would be approximately $3.02. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 2.7x more than what Medicare allows for this procedure. Medicare actually pays $10.97 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Connecticut | $17 | $27 | 5 | 30 | +14.6% |
| New Jersey | $17 | $29 | 9 | 80 | +13.4% |
| Massachusetts | $17 | $49 | 4 | 23 | +13.0% |
| Washington | $17 | $29 | 3 | 18 | +9.5% |
| Illinois | $16 | $50 | 2 | 43 | +8.6% |
| Maryland | $16 | $40 | 76 | 1,955 | +7.7% |
| Michigan | $16 | $38 | 8 | 69 | +6.6% |
| Arizona | $16 | $24 | 1 | 12 | +6.3% |
| California | $16 | $28 | 24 | 118 | +5.5% |
| Kansas | $16 | $32 | 7 | 22 | +4.2% |
| Louisiana | $16 | $36 | 4 | 221 | +3.1% |
| Texas | $15 | $47 | 24 | 1,284 | +0.8% |
| Oregon | $15 | $23 | 6 | 30 | -3.0% |
| Oklahoma | $15 | $41 | 16 | 2,828 | -3.6% |
| Pennsylvania | $14 | $34 | 10 | 21 | -6.0% |
| Idaho | $14 | $52 | 1 | 12 | -6.2% |
| Florida | $14 | $32 | 13 | 22 | -8.9% |
| Mississippi | $14 | $22 | 3 | 480 | -9.3% |
| Tennessee | $13 | $46 | 8 | 469 | -11.0% |
| Arkansas | $13 | $45 | 2 | 17 | -12.6% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber