Medication assisted treatment, buprenorphine (oral); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opi
Medicare pricing data for 442 providers across 27 states
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
Medication assisted treatment, buprenorphine (oral); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opi (HCPCS code G2068) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $264.83, but hospitals typically charge $318.29 — a 1.2x 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 $264.83, your out-of-pocket cost would be approximately $52.97. 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 1.2x more than what Medicare allows for this procedure. Medicare actually pays $260.27 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Illinois | $296 | $762 | 7 | 239 | +11.7% |
| New Jersey | $292 | $307 | 15 | 742 | +10.3% |
| Florida | $284 | $709 | 17 | 349 | +7.2% |
| Virginia | $282 | $305 | 18 | 598 | +6.4% |
| Oregon | $281 | $303 | 8 | 235 | +6.1% |
| Washington | $281 | $370 | 11 | 532 | +6.0% |
| Maryland | $280 | $297 | 42 | 2,838 | +5.7% |
| Arizona | $279 | $357 | 14 | 277 | +5.4% |
| Vermont | $278 | $306 | 6 | 1,082 | +5.1% |
| Ohio | $275 | $312 | 24 | 4,842 | +3.7% |
| Louisiana | $274 | $280 | 5 | 124 | +3.6% |
| West Virginia | $273 | $279 | 5 | 368 | +3.3% |
| Minnesota | $272 | $323 | 6 | 265 | +2.6% |
| South Carolina | $272 | $295 | 12 | 580 | +2.5% |
| Wisconsin | $271 | $322 | 12 | 452 | +2.4% |
| Pennsylvania | $271 | $282 | 6 | 250 | +2.4% |
| Iowa | $271 | $293 | 4 | 178 | +2.4% |
| Georgia | $271 | $286 | 12 | 538 | +2.3% |
| Kentucky | $270 | $297 | 6 | 235 | +2.1% |
| California | $268 | $279 | 69 | 3,615 | +1.3% |
| Tennessee | $268 | $280 | 10 | 280 | +1.1% |
| Texas | $266 | $504 | 21 | 525 | +0.4% |
| Rhode Island | $261 | $266 | 2 | 229 | -1.4% |
| Delaware | $258 | $265 | 5 | 284 | -2.4% |
| New York | $246 | $539 | 9 | 418 | -7.3% |
| Michigan | $238 | $267 | 7 | 146 | -10.1% |
| North Carolina | $198 | $260 | 37 | 3,013 | -25.3% |
⚠️ 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