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 Pennsylvania
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
Pennsylvania Pricing in Context
In Pennsylvania, 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 $268.25 — 3% above the national benchmark of $260.27. 6 providers across the state submitted claims for this procedure in 2023, performing 250 total services. Individual payments in PA 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 Pennsylvania is $281.78, 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 Pennsylvania sits above the national Medicare average, commercial rates in the state may also run higher than the US median.
Using RAND 2024 commercial-to-Medicare ratios for Temporary Procedures procedures, the estimated commercial insurance price in Pennsylvania lands near $596.59, with self-pay cash prices typically around $280.87. 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 Pennsylvania?
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 Pennsylvania is $268.25, which is 3% above the national average of $260.27. Providers in PA typically bill $281.78 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 Pennsylvania?
With commercial insurance in Pennsylvania, 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 $596.59. Without insurance, the estimated cash price is $280.87. 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 Pennsylvania?
6 providers in Pennsylvania 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 250 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 Pennsylvania than the national average?
No — 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 3% above the national average in Pennsylvania. The state average Medicare payment is $268.25 compared to $260.27 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.
Related Guides
Related Data Sources
Data from CMS Medicare Physician & Other Practitioners (2023).
Read our methodology — how this data is sourced, computed, and verified.