Office-Based Treatment For Opioid Use Disorder, Including Development Of The Treatment Plan, Care Coordination, Individual Therapy And Group Therapy And Counseling; At Least 70 Minutes In The First Calendar Month in Massachusetts
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
Massachusetts Pricing in Context
In Massachusetts, CPT code G2086 (Office-Based Treatment For Opioid Use Disorder, Including Development Of The Treatment Plan, Care Coordination, Individual Therapy And Group Therapy And Counseling; At Least 70 Minutes In The First Calendar Month) carries an average Medicare payment of $237.40 — 9% below the national benchmark of $260.19. 16 providers across the state submitted claims for this procedure in 2023, performing 23 total services. Individual payments in MA 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 Massachusetts is $584.16, 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 Massachusetts 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 Massachusetts lands near $815.99, with self-pay cash prices typically around $396.02. 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 Office-Based Treatment For Opioid Use Disorder, Including Development Of The Treatment Plan, Care Coordination, Individual Therapy And Group Therapy And Counseling; At Least 70 Minutes In The First Calendar Month cost in Massachusetts?
The average Medicare payment for Office-Based Treatment For Opioid Use Disorder, Including Development Of The Treatment Plan, Care Coordination, Individual Therapy And Group Therapy And Counseling; At Least 70 Minutes In The First Calendar Month in Massachusetts is $237.40, which is 9% below the national average of $260.19. Providers in MA typically bill $584.16 for this procedure.
What does Office-Based Treatment For Opioid Use Disorder, Including Development Of The Treatment Plan, Care Coordination, Individual Therapy And Group Therapy And Counseling; At Least 70 Minutes In The First Calendar Month cost with insurance in Massachusetts?
With commercial insurance in Massachusetts, Office-Based Treatment For Opioid Use Disorder, Including Development Of The Treatment Plan, Care Coordination, Individual Therapy And Group Therapy And Counseling; At Least 70 Minutes In The First Calendar Month costs an estimated $815.99. Without insurance, the estimated cash price is $396.02. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.
How many providers perform Office-Based Treatment For Opioid Use Disorder, Including Development Of The Treatment Plan, Care Coordination, Individual Therapy And Group Therapy And Counseling; At Least 70 Minutes In The First Calendar Month in Massachusetts?
16 providers in Massachusetts billed Medicare for Office-Based Treatment For Opioid Use Disorder, Including Development Of The Treatment Plan, Care Coordination, Individual Therapy And Group Therapy And Counseling; At Least 70 Minutes In The First Calendar Month in 2023, performing 23 total services. Medicare payments ranged from N/A to N/A depending on the provider.
Is Office-Based Treatment For Opioid Use Disorder, Including Development Of The Treatment Plan, Care Coordination, Individual Therapy And Group Therapy And Counseling; At Least 70 Minutes In The First Calendar Month cheaper in Massachusetts than the national average?
Yes — Office-Based Treatment For Opioid Use Disorder, Including Development Of The Treatment Plan, Care Coordination, Individual Therapy And Group Therapy And Counseling; At Least 70 Minutes In The First Calendar Month costs 9% below the national average in Massachusetts. The state average Medicare payment is $237.40 compared to $260.19 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.