Missouri · G2087

Office-Based Treatment For Opioid Use Disorder, Including Care Coordination, Individual Therapy And Group Therapy And Counseling; At Least 60 Minutes In A Subsequent Calendar Month in Missouri

Missouri Medicare Avg
$244.72
4% above national avg
National Medicare Avg
$235.60
All states combined
Billed Charge (MO)
$393.10
What providers submit
Est. Commercial (MO)
$665.34
National avg: $673.00
Est. Cash / Self-Pay (MO)
$348.01
Typical self-pay discount

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

71
Services in MO
3
Providers
N/A
Min Payment
N/A
Max Payment

Missouri Pricing in Context

In Missouri, CPT code G2087 (Office-Based Treatment For Opioid Use Disorder, Including Care Coordination, Individual Therapy And Group Therapy And Counseling; At Least 60 Minutes In A Subsequent Calendar Month) carries an average Medicare payment of $244.72 — 4% above the national benchmark of $235.60. 3 providers across the state submitted claims for this procedure in 2023, performing 71 total services. Individual payments in MO 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 Missouri is $393.10, 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 Missouri 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 Missouri lands near $665.34, with self-pay cash prices typically around $348.01. 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 Care Coordination, Individual Therapy And Group Therapy And Counseling; At Least 60 Minutes In A Subsequent Calendar Month cost in Missouri?

The average Medicare payment for Office-Based Treatment For Opioid Use Disorder, Including Care Coordination, Individual Therapy And Group Therapy And Counseling; At Least 60 Minutes In A Subsequent Calendar Month in Missouri is $244.72, which is 4% above the national average of $235.60. Providers in MO typically bill $393.10 for this procedure.

What does Office-Based Treatment For Opioid Use Disorder, Including Care Coordination, Individual Therapy And Group Therapy And Counseling; At Least 60 Minutes In A Subsequent Calendar Month cost with insurance in Missouri?

With commercial insurance in Missouri, Office-Based Treatment For Opioid Use Disorder, Including Care Coordination, Individual Therapy And Group Therapy And Counseling; At Least 60 Minutes In A Subsequent Calendar Month costs an estimated $665.34. Without insurance, the estimated cash price is $348.01. 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 Care Coordination, Individual Therapy And Group Therapy And Counseling; At Least 60 Minutes In A Subsequent Calendar Month in Missouri?

3 providers in Missouri billed Medicare for Office-Based Treatment For Opioid Use Disorder, Including Care Coordination, Individual Therapy And Group Therapy And Counseling; At Least 60 Minutes In A Subsequent Calendar Month in 2023, performing 71 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Office-Based Treatment For Opioid Use Disorder, Including Care Coordination, Individual Therapy And Group Therapy And Counseling; At Least 60 Minutes In A Subsequent Calendar Month cheaper in Missouri than the national average?

No — Office-Based Treatment For Opioid Use Disorder, Including Care Coordination, Individual Therapy And Group Therapy And Counseling; At Least 60 Minutes In A Subsequent Calendar Month costs 4% above the national average in Missouri. The state average Medicare payment is $244.72 compared to $235.60 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