Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; each additional 30 minutes beyond the first 120 minutes (list separately in addition to code for primary procedure)
Medicare pricing data for 459 providers across 19 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; each additional 30 minutes beyond the first 120 minutes (list separately in addition to code for primary procedure) (HCPCS code G2088) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $46.46, but hospitals typically charge $109.26 — a 2.4x 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 $46.46, your out-of-pocket cost would be approximately $9.29. 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 2.4x more than what Medicare allows for this procedure. Medicare actually pays $36.64 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Kentucky | $52 | $182 | 70 | 2,201 | +12.2% |
| North Carolina | $52 | $162 | 7 | 56 | +11.6% |
| Ohio | $51 | $98 | 79 | 3,114 | +9.5% |
| Michigan | $50 | $125 | 3 | 272 | +7.5% |
| Alabama | $49 | $105 | 4 | 29 | +5.9% |
| West Virginia | $48 | $277 | 9 | 88 | +4.0% |
| Virginia | $48 | $105 | 47 | 1,095 | +3.5% |
| Massachusetts | $47 | $86 | 17 | 122 | +2.2% |
| Illinois | $46 | $164 | 3 | 28 | -0.1% |
| Tennessee | $45 | $171 | 61 | 795 | -3.7% |
| Oregon | $44 | $97 | 4 | 38 | -6.3% |
| Arizona | $43 | $65 | 4 | 235 | -7.2% |
| Indiana | $42 | $65 | 49 | 3,465 | -8.8% |
| Maine | $42 | $68 | 18 | 437 | -9.5% |
| Vermont | $42 | $85 | 7 | 84 | -10.0% |
| New Hampshire | $41 | $91 | 30 | 796 | -12.6% |
| Rhode Island | $40 | $85 | 2 | 41 | -14.4% |
| Washington | $39 | $100 | 4 | 257 | -16.4% |
| Florida | $36 | $99 | 11 | 367 | -21.7% |
⚠️ 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