North Carolina · G2068

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 in North Carolina

North Carolina Medicare Avg
$194.28
25% below national avg
National Medicare Avg
$260.27
All states combined
Billed Charge (NC)
$260.32
What providers submit
Est. Commercial (NC)
$431.33
National avg: $593.22
Est. Cash / Self-Pay (NC)
$219.98
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

3.0K
Services in NC
37
Providers
N/A
Min Payment
N/A
Max Payment

Top Providers in North Carolina

Provider Medicare Services
Bear Island Recovery Services, Inc. $39.27 943
Ats Of North Carolina, Llc $271.19 407
Addiction Recovery Medical Services $269.12 344

North Carolina Pricing in Context

In North Carolina, CPT code G2068 (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) carries an average Medicare payment of $194.28 — 25% below the national benchmark of $260.27. 37 providers across the state submitted claims for this procedure in 2023, performing 3.0K total services. Individual payments in NC ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in North Carolina is $260.32, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because North Carolina sits below the national Medicare average, commercial rates in the state may also run lower than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Temporary Procedures procedures, the estimated commercial insurance price in North Carolina lands near $431.33, with self-pay cash prices typically around $219.98. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does 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 cost in North Carolina?

The average Medicare payment for 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 in North Carolina is $194.28, which is 25% below the national average of $260.27. Providers in NC typically bill $260.32 for this procedure.

What does 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 cost with insurance in North Carolina?

With commercial insurance in North Carolina, 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 costs an estimated $431.33. Without insurance, the estimated cash price is $219.98. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform 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 in North Carolina?

37 providers in North Carolina billed Medicare for 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 in 2023, performing 3.0K total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is 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 cheaper in North Carolina than the national average?

Yes — 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 costs 25% below the national average in North Carolina. The state average Medicare payment is $194.28 compared to $260.27 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial