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See a sample rate comparisonHCPCS G2086 Fee Schedule
Medicare rates as of October 2026
HCPCS G2086 is classified under Procedures / Professional Services, in the Opioid Use Disorder - Treatment (Office Based) subgroup.
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
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Opioid Use Disorder - Treatment (Office Based) |
| Complexity Level | Moderate |
| ASAM Level | Level 1 - Outpatient Services |
| Care Type | Medication Assisted Treatment |
| Setting | Outpatient |
| Medicare Fee Schedule | $491.33 national non-facility rate (2026) · View Medicare rates for G2086 |
| Medicaid Fee Schedule | $393.19 median of the 7 states in the free preview · View Medicaid rates for G2086 |
National average reimbursement for HCPCS G2086 by major payers:
$501.76
BCBS / Anthem
$523.27
UnitedHealthcare
$391.06
Aetna
$494.21
Cigna
Compare published rates across providers.
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HCPCS G2086
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$993.52Published rateChristopher Chambers
Cooperative Healthcare Services Inc
$590.86Published rateTexas Radiology Associates LLP
Texas Radiology Associates, LLP
$453.42Published rateParish Hospital Service District For The Parish Of Orleans, New Orleans East Hospital
$262.98Published rateClhg-Winn, LLC, Winn Parish Medical Center
$180.19Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G2086 vs. Other Opioid Use Disorder - Treatment (Office Based) Codes
The table lists codes related to G2086. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G2083-HCPCS | High | Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self-administration, includes 2 hours post-administration observation |
| G2086-HCPCS | Moderate | 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 |
| G2087-HCPCS | Moderate | 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 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G2086. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G2086 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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