Wisconsin · 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 Wisconsin

Wisconsin Medicare Avg
$265.55
2% above national avg
National Medicare Avg
$260.27
All states combined
Billed Charge (WI)
$322.36
What providers submit
Est. Commercial (WI)
$575.07
National avg: $593.22
Est. Cash / Self-Pay (WI)
$292.09
Typical self-pay discount

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

452
Services in WI
12
Providers
N/A
Min Payment
N/A
Max Payment

Wisconsin Pricing in Context

In Wisconsin, 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 $265.55 — 2% above the national benchmark of $260.27. 12 providers across the state submitted claims for this procedure in 2023, performing 452 total services. Individual payments in WI 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 Wisconsin is $322.36, 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 Wisconsin 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 Wisconsin lands near $575.07, with self-pay cash prices typically around $292.09. 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 Wisconsin?

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 Wisconsin is $265.55, which is 2% above the national average of $260.27. Providers in WI typically bill $322.36 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 Wisconsin?

With commercial insurance in Wisconsin, 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 $575.07. Without insurance, the estimated cash price is $292.09. 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 Wisconsin?

12 providers in Wisconsin 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 452 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 Wisconsin 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 2% above the national average in Wisconsin. The state average Medicare payment is $265.55 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