How much does Medicare pay for HCPCS G2076?

Medicare allowed an average of $195.81 per service and paid $184.51 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $254.85, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

Which specialty bills G2076 most?

Opioid Treatment Program, with 2,864 services from 71 clinicians.

HCPCS G2076

Intake activities, including initial medical examination that is a complete, fully documented physical evaluation and initial assessment by a program physician or a primary care physician, or an authorized healthcare professional under the supervision of a

$195.81Medicare-allowed amount per service, averaged across 2,864 services

Providers submitted

$254.85

Asking price, not received

Medicare allowed

$195.81

The fee schedule figure

Medicare paid

$184.51

Balance is patient coinsurance

Providers submitted an average of $254.85 for this code and Medicare allowed $195.81 — 1.3× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $184.51 (94%); the rest is the patient’s coinsurance and deductible.

Services: 2,864
Beneficiaries: 1,682
Providers billing it: 71
Total allowed: $560,800

What Medicare pays for HCPCS G2076

Across 2,864 services billed by 71 providers to 1,682 beneficiaries, Medicare allowed an average of $195.81 per service. That is 1.7 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills G2076

Specialty	Services	Beneficiaries	Avg allowed	Providers
Opioid Treatment Program	2,864	1,682	$195.81	71

G2076 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
North Carolina	817	$188.31	$183.15	2
Massachusetts	579	$205.91	$192.43	6
California	308	$201.81	$181.07	17
Michigan	277	$202.16	$201.48	2
Maryland	197	$201.75	$189.47	11
New York	137	$167.24	$164.63	4
Oregon	116	$199.05	$164.34	6
Ohio	61	$186.91	$186.24	2
New Hampshire	58	$199.92	$175.34	3
Connecticut	45	$209.96	$209.96	2
West Virginia	43	$184.50	$162.20	3
Washington	39	$190.02	$179.68	2
Indiana	38	$183.86	$173.99	1
Florida	30	$196.42	$176.51	1
New Jersey	26	$212.09	$203.78	2
Maine	25	$186.66	$166.27	2
Wisconsin	17	$187.49	$153.85	1
Virginia	15	$195.06	$168.59	1
Vermont	14	$191.13	$153.73	1
Arizona	11	$194.69	$176.66	1
Idaho	11	$186.41	$117.75	1

Related codes

G2067Medication assisted treatment$225.81
G2078Take-home supply of methadone; up to 7 additional day supply (provisio$39.17
G2012Brief communication technology-based service$13.77
G2077Periodic assessment; assessing periodically by qualified personnel to$121.19
G2074Medication assisted treatment$204.11
G2083Office or other outpatient visit for the evaluation and management of$1215.85
G2011Alcohol and/or substance (other than tobacco) misuse structured assess$15.58
G2087Office-based treatment for opioid use disorder$367.01
G2068Medication assisted treatment$281.73
G2080Each additional 30 minutes of counseling in a week of medication assis$35.16
G2088Office-based treatment for opioid use disorder$49.83
G2010Remote evaluation of recorded video and/or images submitted by an esta$11.93

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.