Average Medicaid Substance Abuse Treatment Payments in Rochester, NY: $66.55
Avg. Paid
$66.55
Range
$10.87 – $235.76
Total Claims
788,422
Providers
44
Typical Payment Range
Typical Medicaid Substance Abuse Treatment payments fall between $34.14 and $105.27 per claim (median: $65.20). The top 10% of payments exceed $163.43.
Based on per-provider averages across all Medicaid claims in this category.
Treatment programs for substance use disorders, including detoxification, counseling, medication-assisted treatment (MAT), and rehabilitation services.
Understanding these costs
The amounts shown are Medicaid reimbursement rates — what state Medicaid programs paid providers per claim. Medicaid typically pays well below private insurance rates and out-of-pocket prices. Use this data to compare relative costs between providers, not as a price estimate for privately insured or self-pay patients.
Providers Offering Substance Abuse Treatment in Rochester, NY
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Claire Phillilps Stutzman
1815 Clinton Ave S |
$30.25 | 12 | 12 |
|
Michael David Simson
224 Alexander St |
$143.28 | 13 | 13 |
|
David Sullo
220 Linden Oaks |
$33.00 | 13 | 13 |
|
Jennifer Cromwell
490 E Ridge Rd |
$35.22 | 18 | 13 |
|
Catholic Charities Of The Diocese Rochester Inc
1099 Jay Street, Building J |
$133.87 | 21 | 12 |
|
Susan G Miller
500 Helendale Rd |
$33.00 | 29 | 29 |
|
Compeer Rochester, Inc.
259 Monroe Avenue |
$64.84 | 39 | 12 |
|
David Flaherty
224 Alexander St |
$53.98 | 47 | 14 |
|
Daniellle R Stratton
1800 English Rd Ste 10 |
$33.00 | 48 | 48 |
|
Karen Susan Penird
500 Helendale Rd |
$32.38 | 53 | 53 |
|
James Thomas Mulholland
1425 Portland Ave |
$32.79 | 84 | 84 |
|
Charles W Morgan
1111 Elmwood Ave |
$84.96 | 90 | 50 |
|
Laurie Caroline Shin
1800 English Rd |
$33.00 | 95 | 95 |
|
Madeline Sanquiche
85 Metro Park |
$131.44 | 111 | 111 |
|
Olutoyin Modupe Malomo
1800 English Rd |
$33.00 | 128 | 128 |
|
Karla Suter
1800 English Rd. |
$32.87 | 143 | 143 |
|
Huther Doyle Memorial Institute
360 East Ave |
$47.81 | 225 | 81 |
|
Melissa Beisheim
1800 English Rd |
$32.76 | 283 | 283 |
|
Mental Health Association Of Rochester/Monroe County, Inc.
274 N Goodman St Ste D103 |
$27.73 | 336 | 185 |
|
Kevin George O'Gara
1800 English Rd Ste 10 |
$32.85 | 356 | 356 |
|
Huther Doyle Memorial Institute
360 East Ave |
$47.85 | 765 | 185 |
|
Gordon Botchway
361 Chili Ave |
$26.67 | 1,005 | 236 |
|
Richard Scott Dent
1565 Long Pond Rd |
$21.64 | 1,159 | 307 |
|
University Of Rochester
601 Elmwood Ave |
$27.37 | 1,268 | 85 |
|
The Unity Hospital Of Rochester
81 Lake Ave |
$96.34 | 1,432 | 647 |
|
Robert L Weisman
601 Elmwood Ave |
$185.77 | 2,506 | 1,070 |
|
Villa Of Hope
3300 Dewey Ave |
$93.52 | 6,225 | 2,262 |
|
Tina Marie Adams
1555 Long Pond Rd |
$10.87 | 6,898 | 2,382 |
|
Catholic Charities Of The Diocese Of Rochester
997 Saint Paul St |
$148.11 | 7,102 | 342 |
|
Myra L. Mathis-Uwanogho
300 Crittenden Blvd |
$235.76 | 11,045 | 3,822 |
|
Baden Street Settlement Of Rochester, Inc
585 Joseph Ave |
$56.87 | 11,370 | 3,384 |
|
Delphi Drug & Alcohol Council, Inc
72 Hinchey Rd |
$67.95 | 17,978 | 10,684 |
|
Rochester General Hospital
1425 Portland Ave |
$74.53 | 20,031 | 10,492 |
|
East House Corp
259 Monroe Ave., Ste. 200 |
$102.16 | 23,680 | 925 |
|
Catholic Charities Of The Diocese Of Rochester
146 Hobart St |
$152.23 | 25,439 | 1,302 |
|
Huther-Doyle Memorial Institute Inc
360 East Ave |
$61.76 | 25,880 | 9,437 |
|
Gloria J Baciewicz
300 Crittenden Blvd |
$67.34 | 27,431 | 4,381 |
|
U Of R Neurology Department
601 Elmwood Ave |
$28.57 | 37,608 | 2,935 |
|
Action For A Better Community, Inc.
Action Of A Better Community, Inc. |
$50.19 | 39,185 | 5,909 |
|
Conifer Park, Inc.
556 Clinton Ave S |
$51.47 | 41,560 | 7,973 |
|
Hillside Childrens Center
1183 Monroe Avenue |
$101.31 | 53,614 | 13,232 |
|
Catholic Charities Of The Diocese Of Rochester
79 N Clinton Ave |
$115.97 | 68,056 | 9,577 |
|
The Unity Hospital Of Rochester
81 Lake Ave |
$75.97 | 114,069 | 41,825 |
|
University Of Rochester
601 Elmwood Ave |
$29.33 | 240,972 | 20,195 |
What to Expect: Substance Abuse Treatment
Substance abuse treatment varies widely based on the program. Outpatient treatment involves regular counseling sessions and may include medication-assisted treatment (like Suboxone or methadone). Intensive outpatient programs (IOP) involve 9-20 hours per week of structured treatment. Individual counseling, group therapy, and peer support are common components.
Cost Components
National average Medicaid payment per billing code. Individual rates vary by provider and state.
| Code | Description | Avg. Paid | Claims | Providers |
|---|---|---|---|---|
| H0020 | Alcohol and/or drug services | $20.02 | 312,323,784 | 3,904 |
| H0004 | Alcohol and/or drug services | $89.45 | 73,272,784 | 23,966 |
| H0038 | Self-help/peer svc per 15min | $102.60 | 30,385,812 | 7,670 |
| H0015 | Alcohol and/or drug services | $152.04 | 25,053,675 | 9,061 |
| H0005 | Alcohol and/or drug services | $53.46 | 23,222,742 | 9,936 |
| H2036 | A/d tx program, per diem | $258.14 | 18,209,988 | 1,399 |
| H0023 | Alcohol and/or drug outreach | $129.61 | 9,489,348 | 1,230 |
| H2035 | A/d tx program, per hour | $133.88 | 8,557,719 | 772 |
| H0006 | Alcohol and/or drug services | $58.37 | 8,299,938 | 8,185 |
| H0025 | Alcohol and/or drug preventi | $59.91 | 4,103,530 | 1,218 |
| H0010 | Alcohol and/or drug services | $422.31 | 3,875,371 | 395 |
| H0001 | Alcohol and/or drug assess | $82.04 | 3,265,107 | 5,031 |
| H0002 | Alcohol and/or drug screenin | $50.82 | 3,220,721 | 4,504 |
| H0049 | Alcohol/drug screening | $6.25 | 2,594,750 | 4,239 |
| H0022 | Alcohol and/or drug interven | $34.60 | 942,099 | 951 |
| T1012 | Alcohol/substance abuse skil | $61.60 | 820,776 | 236 |
| H0014 | Alcohol and/or drug services | $206.17 | 618,111 | 786 |
| H0012 | Alcohol and/or drug services | $266.77 | 587,849 | 172 |
| H0050 | Alcohol/drug service 15 min | $39.26 | 340,958 | 472 |
| H0007 | Alcohol and/or drug services | $261.94 | 101,784 | 110 |
| T1006 | Family/couple counseling | $172.57 | 38,563 | 50 |
These are national Medicaid averages for each billing code. Actual amounts vary by state, provider, and complexity.
Frequently Asked Questions
How much does a Substance Abuse Treatment cost in Rochester, NY?
Based on public Medicaid payment data, the average Medicaid reimbursement for Substance Abuse Treatment in Rochester, NY is $66.55 per claim, based on 788,422 claims from 44 providers. Typical payments fall between $34.14 and $105.27. Note: Medicaid rates are typically much lower than private insurance or self-pay prices.
How many providers offer Substance Abuse Treatment in Rochester, NY?
There are 44 Medicaid providers offering Substance Abuse Treatment related services in Rochester, NY according to public payment data.
What is the price range for Substance Abuse Treatment in Rochester, NY?
Medicaid reimbursement for Substance Abuse Treatment in Rochester, NY ranges from $10.87 to $235.76 per claim, with an average of $66.55. Private insurance and self-pay costs are typically higher than these Medicaid rates.
Substance Abuse Treatment in Other Cities
Hartford, CT
Avg $14.18
12,612,724 claims · 41 providers
Phoenix, AZ
Avg $94.34
10,076,493 claims · 688 providers
Springfield, MA
Avg $20.44
8,386,620 claims · 42 providers
Baltimore, MD
Avg $107.97
7,464,932 claims · 477 providers
Portland, OR
Avg $37.53
6,780,611 claims · 1329 providers
Worcester, MA
Avg $21.52
6,777,067 claims · 53 providers
Bronx, NY
Avg $38.59
6,144,578 claims · 254 providers
Albuquerque, NM
Avg $34.24
5,929,577 claims · 285 providers
Other Procedures in Rochester, NY
Home Health Visit
Avg $155.96
4,468,559 claims
Blood Work & Lab Tests
Avg $13.58
3,406,771 claims
Office Visit
Avg $80.81
3,372,720 claims
Emergency Room Visit
Avg $129.50
1,243,277 claims
Case Management Services
Avg $416.23
1,188,020 claims
Psychiatric Evaluation
Avg $142.49
1,087,559 claims
Physical Therapy
Avg $59.14
727,107 claims
Ambulance Transport
Avg $103.20
693,655 claims