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See a sample rate comparisonHCPCS G2172 Fee Schedule
HCPCS G2172 is classified under Procedures / Professional Services, in the Opioid Use Disorder (OUD) Treatment Services subgroup.
All inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Opioid Use Disorder (OUD) Treatment Services |
| Complexity Level | Low |
National average reimbursement for HCPCS G2172 by major payers:
$58.71
BCBS / Anthem
$N/A
UnitedHealthcare
$49.42
Aetna
$0.00
Cigna
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HCPCS G2172
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See a sample payer proposalHCPCS G2172 vs. Other Opioid Use Disorder (OUD) Treatment Services Codes
The table lists codes related to G2172. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G2169-HCPCS | Low | Services performed by an occupational therapist assistant in the home health setting in the delivery of a safe and effective occupational therapy maintenance program, each 15 minutes |
| G2172-HCPCS | Low | All inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project |
| G2173-HCPCS | Low | Uri episodes where the patient had a comorbid condition during the 12 months prior to or on the episode date (e.g., tuberculosis, neutropenia, cystic fibrosis, chronic bronchitis, pulmonary edema, respiratory failure, rheumatoid lung disease) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G2172. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G2172 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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