West Virginia · 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 West Virginia

West Virginia Medicare Avg
$267.17
3% above national avg
National Medicare Avg
$260.27
All states combined
Billed Charge (WV)
$278.89
What providers submit
Est. Commercial (WV)
$587.89
National avg: $593.22
Est. Cash / Self-Pay (WV)
$281.77
Typical self-pay discount

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

368
Services in WV
5
Providers
N/A
Min Payment
N/A
Max Payment

West Virginia Pricing in Context

In West Virginia, 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 $267.17 — 3% above the national benchmark of $260.27. 5 providers across the state submitted claims for this procedure in 2023, performing 368 total services. Individual payments in WV 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 West Virginia is $278.89, 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 West Virginia 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 West Virginia lands near $587.89, with self-pay cash prices typically around $281.77. 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 West Virginia?

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 West Virginia is $267.17, which is 3% above the national average of $260.27. Providers in WV typically bill $278.89 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 West Virginia?

With commercial insurance in West Virginia, 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 $587.89. Without insurance, the estimated cash price is $281.77. 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 West Virginia?

5 providers in West Virginia 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 368 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 West Virginia 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 West Virginia. The state average Medicare payment is $267.17 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