G0442

Annual alcohol misuse screening, 5 to 15 minutes

Medicare pricing data for 16,524 providers across 52 states

🤖AI Overview

Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Annual alcohol misuse screening, 5 to 15 minutes (HCPCS code G0442) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $17.66, but hospitals typically charge $38.05 — a 2.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.53

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $17.66, your out-of-pocket cost would be approximately $3.53. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$17.66
Average Hospital Charge
$38.05
Markup Ratio
2.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$38.05
Medicare Allowed$17.66
Medicare Payment$17.66

Hospitals charge 2.2x more than what Medicare allows for this procedure. Medicare actually pays $17.66 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$21$5723641+16.7%
Alaska$20$6412192+15.7%
New Jersey$20$4149334,106+13.8%
California$20$401,29978,148+13.0%
New York$20$441,01348,145+12.6%
Maryland$20$3939334,967+10.4%
Massachusetts$19$5452328,643+9.5%
Connecticut$19$431776,786+7.0%
Illinois$19$4033117,601+6.9%
South Dakota$18$58226+4.0%
Virginia$18$3624011,633+2.9%
Pennsylvania$18$3051534,251+2.8%
Delaware$18$34464,339+2.3%
Maine$18$328204+1.8%
Colorado$18$362077,550+1.8%
New Hampshire$18$43501,207+1.7%
Rhode Island$18$38451,930+1.2%
Wyoming$18$39870+0.9%
Nevada$18$4022412,561+0.8%
Montana$18$2420741+0.2%
Florida$18$362,535167,370-0.2%
Michigan$18$3534415,348-0.8%
Puerto Rico$17$2813188-1.1%
North Dakota$17$712152-1.2%
Texas$17$401,69775,559-2.4%
Minnesota$17$4523497-2.6%
Wisconsin$17$45612,043-2.7%
Arizona$17$3371251,816-3.6%
Georgia$17$4357429,692-3.8%
Vermont$17$27341,681-4.0%
Indiana$17$391507,362-4.4%
North Carolina$17$3772832,489-4.5%
Utah$17$30441,682-4.7%
Kansas$17$401197,044-6.1%
Missouri$17$291023,303-6.1%
Idaho$16$35391,157-7.7%
West Virginia$16$30671,524-7.7%
Tennessee$16$4337322,374-7.8%
Oklahoma$16$3220712,035-7.9%
Louisiana$16$401495,916-8.4%
Iowa$16$49701,737-9.1%
Alabama$16$3253923,081-9.1%
New Mexico$16$471165,176-9.2%
Ohio$16$3342517,917-9.6%
Oregon$16$393618,873-9.8%
Nebraska$16$26693,132-10.4%
Arkansas$16$3225315,226-10.5%
South Carolina$15$3925716,732-14.2%
Kentucky$15$271425,603-15.5%
Washington$14$402827,947-20.1%
Mississippi$13$2936528,004-24.9%
Hawaii$12$2114798-32.8%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber