G2067

Medication assisted treatment, methadone; 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 opioid treatm

Code G2067. Medicare covered 868,503 of these. Here is what providers billed and what Medicare allowed, state by state.

$274.83Billed, national avg
$224.78Medicare allowed
1.2xBilled vs allowed
6.4xHighest vs lowest state

Providers in Mississippi billed the most for this, at $485.61. In Nevada the average was $75.41. Same procedure code, same programme.

Whose price this is

These are Medicare figures. The billed column is what providers asked for. The allowed column is what Medicare agreed to pay. Neither is what an uninsured patient gets charged, and neither is what a private insurer negotiates.

The gap between the two columns is the point. A hospital billing three times what Medicare allows tells you the billed number was never a price. It was an opening position.

By state

StateBilledMedicare allowedGapServices
Mississippi$485.61$237.552.0x1,301
New Hampshire$447.94$253.391.8x12,953
Alaska$441.44$303.871.5x3,051
Florida$435.11$250.291.7x18,269
Missouri$429.41$244.561.8x3,343
South Carolina$387.47$235.611.6x8,777
Virginia$385.17$249.951.5x12,047
Georgia$354.22$247.001.4x15,331
Ohio$344.49$242.851.4x9,811
New Jersey$331.30$267.741.2x29,806
Maine$328.69$240.481.4x11,060
Kentucky$327.84$238.941.4x12,408
Minnesota$315.62$242.271.3x11,794
New Mexico$311.73$244.071.3x7,537
Connecticut$311.15$262.761.2x18,143
North Carolina$308.69$225.601.4x17,035
Montana$307.58$254.491.2x1,846
Pennsylvania$303.54$229.111.3x29,333
North Dakota$302.10$250.301.2x1,190
Oregon$292.70$249.781.2x12,711
Hawaii$286.79$244.731.2x1,483
New York$281.90$251.801.1x40,538
Massachusetts$281.09$265.371.1x86,145
Colorado$279.94$258.381.1x7,443
Michigan$278.75$246.171.1x21,655
Maryland$275.27$257.061.1x65,123
Indiana$274.12$238.841.1x12,638
Oklahoma$273.29$240.221.1x6,019
District of Columbia$271.21$265.911.0x3,968
Wisconsin$271.03$242.941.1x12,175
Illinois$268.59$244.291.1x13,567
Washington$267.84$253.571.1x18,227
Texas$262.81$195.311.3x14,388
Rhode Island$259.58$252.391.0x5,061
Utah$253.61$217.111.2x3,094
Idaho$251.39$240.781.0x1,249
Kansas$251.32$238.791.1x2,493
Louisiana$247.50$242.671.0x4,619
West Virginia$245.41$239.971.0x7,073
Tennessee$245.31$238.791.0x11,200
Vermont$245.18$229.941.1x9,790
Nebraska$244.62$239.561.0x659
Arizona$244.54$186.401.3x13,913
Arkansas$240.28$234.001.0x866
Iowa$232.73$222.711.0x1,947
California$231.62$186.231.2x213,641
Alabama$221.12$143.201.5x22,378
Delaware$200.99$195.801.0x5,685
Nevada$75.41$73.891.0x23,648

Source: CMS Medicare Physician & Other Practitioners, by Geography and Service. Weighted by service volume across places of service.

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