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See a sample rate comparisonHCPCS J0572 (Buprenorphine Naloxone) Fee Schedule
HCPCS J0572 is classified under Drugs Administered Other than Oral Method, in the Drugs, Administered by Injection subgroup.
Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | 11 - Office 57 - Non-residential Substance Abuse Treatment Facility 58 - Non-residential Opioid Treatment Facility |
| Complexity Level | Low |
| Medicaid Fee Schedule | $3.02 median of the 8 states in the free preview · View Medicaid rates for J0572 |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J0572 by major payers:
$34.19
BCBS / Anthem
$7.22
UnitedHealthcare
$4.13
Aetna
$4.79
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS J0572.
HCPCS J0572
5 of 25 sample ratesHigher to lower in this preview
Takoma Regional Hospital Inc, Ballad Health Medical Associates
Takoma Regional Hospital Inc
$44.45Published rateFairview Health Services, Fairview Lakes Regional Medical Center
Fairview Health Services
$12.90Published rateForrest County General Hospital, Highland Community Hospital
Forrest County General Hospital
$7.11Published rateCocke County Hma, LLC, Tennova Healthcare-Newport Medical Center
Cocke County Hma LLC
$7.11Published rateBoston Vamc
$7.11Published rate
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Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
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See a sample payer proposalHCPCS J0572 vs. Other Drugs, Administered by Injection Codes
The table lists codes related to J0572. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| J0571-HCPCS | Low | Buprenorphine, oral, 1 mg |
| J0572-HCPCS | Low | Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine |
| J0573-HCPCS | Low | Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J0572. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J0572 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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