go back

Extended Substance Use Screening And Counseling

Massachusetts rates for HCPCS 99409

This is a structured screening for alcohol or drug use paired with a brief counseling conversation about the results, lasting more than thirty minutes. A clinician or trained staff member uses a standardized questionnaire to assess use patterns and then discusses next steps with the patient. The longer time reflects a more in-depth conversation than a brief check-in.

Rates data updated July 2026.

How much does Extended Substance Use Screening And Counseling cost?

$66.07

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $66.07 for this service. The price depends on where it is billed: about $66.07 from a physician practice, and about $75.86 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$66.07$54.95 to $81.28
FacilityA hospital or hospital-owned outpatient department$75.86$70.79 to $85.11

How much rates vary

Facilitymedian $76 · 10th to 90th $69 to $100Professionalmedian $66 · 10th to 90th $49 to $115
$20.0$50.0$100.0$200.0$500.0$1.0Kfacility $76professional $66

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$75.86
Typical High
$100.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$61.66
Typical High
$85.11
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$954.99
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$83.18
Typical High
$194.98
BCBS
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$95.50
Typical High
$204.17
BCBS
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$91.20
Typical High
$173.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$107.15
Typical High
$186.21
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$54.95
Typical High
$95.50
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$67.61
Typical High
$114.82
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$91.20
Typical High
$165.96
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$954.99
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$83.18
Typical High
$194.98
United
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$70.79
Typical High
$83.18
United
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$81.28
Typical High
$158.49

Where Massachusetts sits

Rates are fairly even across states for this service. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Massachusetts $66.07 · 6th of 51
VT $69.18AZ $56.23

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.