Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month
Medicare pricing data for 810 providers across 35 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
Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month (HCPCS code G2087) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $300.45, but hospitals typically charge $543.28 — a 1.8x 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 $300.45, your out-of-pocket cost would be approximately $60.09. 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 1.8x more than what Medicare allows for this procedure. Medicare actually pays $235.60 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| New Mexico | $363 | $383 | 2 | 80 | +20.8% |
| California | $362 | $513 | 12 | 182 | +20.6% |
| Illinois | $356 | $392 | 8 | 378 | +18.6% |
| Pennsylvania | $353 | $594 | 19 | 173 | +17.6% |
| New York | $338 | $442 | 6 | 66 | +12.6% |
| Louisiana | $336 | $396 | 4 | 39 | +11.9% |
| Delaware | $333 | $396 | 3 | 303 | +10.7% |
| Minnesota | $328 | $406 | 2 | 70 | +9.2% |
| Georgia | $328 | $570 | 4 | 224 | +9.2% |
| Oklahoma | $326 | $700 | 1 | 47 | +8.5% |
| Colorado | $325 | $523 | 3 | 45 | +8.2% |
| Ohio | $322 | $440 | 97 | 2,022 | +7.1% |
| Missouri | $320 | $393 | 3 | 71 | +6.5% |
| New Jersey | $317 | $943 | 19 | 247 | +5.4% |
| Washington | $310 | $626 | 6 | 164 | +3.1% |
| North Carolina | $308 | $506 | 14 | 160 | +2.6% |
| Florida | $307 | $532 | 17 | 269 | +2.3% |
| Tennessee | $305 | $643 | 140 | 4,045 | +1.5% |
| Oregon | $304 | $601 | 6 | 42 | +1.1% |
| Mississippi | $304 | $549 | 9 | 399 | +1.0% |
| Texas | $303 | $672 | 14 | 205 | +1.0% |
| Massachusetts | $303 | $479 | 36 | 226 | +0.9% |
| Alabama | $302 | $525 | 8 | 379 | +0.4% |
| Vermont | $302 | $480 | 7 | 124 | +0.4% |
| Arkansas | $300 | $336 | 14 | 1,074 | +0.0% |
| Michigan | $298 | $557 | 11 | 131 | -0.8% |
| Kentucky | $296 | $716 | 98 | 1,526 | -1.6% |
| Maine | $293 | $376 | 19 | 193 | -2.5% |
| New Hampshire | $282 | $573 | 33 | 923 | -6.0% |
| Indiana | $281 | $391 | 60 | 1,561 | -6.3% |
| Rhode Island | $281 | $503 | 2 | 52 | -6.5% |
| Arizona | $279 | $367 | 7 | 92 | -7.2% |
| Virginia | $274 | $567 | 97 | 2,042 | -8.9% |
| Nevada | $261 | $488 | 5 | 555 | -13.0% |
| West Virginia | $249 | $659 | 12 | 207 | -17.1% |
⚠️ 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