Average Medicaid Substance Abuse Treatment Payments
Typical Medicaid Substance Abuse Treatment reimbursement across 5,169 cities
Avg. Medicaid Paid
$58.84
Price Range
$0.00 – $10,105
Total Claims
490.4M
Cities
5169
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.
About This Procedure
Treatment programs for substance use disorders, including detoxification, counseling, medication-assisted treatment (MAT), and rehabilitation services.
Why do these costs look low?
These figures represent Medicaid reimbursement rates — the amounts that state Medicaid programs actually paid providers. Medicaid typically reimburses significantly less than private insurance or out-of-pocket prices. If you have private insurance or are paying cash, expect higher costs. See the cost components below for per-code averages.
Costs by City
| City | Avg. Paid | Min / Max | Claims | Providers |
|---|---|---|---|---|
| Reseda, CA | $29.29 | $0.00 – $329.45 | 475,313 | 4 |
| Albany, NY | $113.47 | $40.42 – $286.59 | 475,654 | 29 |
| Wilson, NC | $125.52 | $26.85 – $171.38 | 477,537 | 5 |
| El Centro, CA | $43.00 | $0.07 – $218.69 | 480,847 | 4 |
| Rochester, MN | $161.27 | $13.02 – $2,014 | 481,555 | 43 |
| Antioch, CA | $28.30 | $0.00 – $271.73 | 481,971 | 6 |
| Wilmington, CA | $22.73 | $0.00 – $104.28 | 482,039 | 4 |
| Chillicothe, OH | $107.40 | $0.00 – $382.78 | 484,851 | 212 |
| Lumberton, NC | $90.17 | $20.86 – $268.12 | 486,602 | 16 |
| Harrisonburg, VA | $34.57 | $7.68 – $326.54 | 488,784 | 8 |
| Waukesha, WI | $11.31 | $3.78 – $46.80 | 490,331 | 55 |
| Wheeler, OR | $9.52 | $9.52 – $9.52 | 492,289 | 1 |
| Bettendorf, IA | $14.51 | $13.93 – $75.77 | 496,752 | 3 |
| Providence, RI | $47.48 | $0.00 – $226.19 | 496,940 | 48 |
| Ashland, KY | $95.73 | $0.00 – $506.70 | 505,064 | 53 |
| Somerset, KY | $133.37 | $0.00 – $276.93 | 507,692 | 62 |
| Hemet, CA | $29.17 | $0.00 – $293.02 | 507,854 | 28 |
| Hamilton, OH | $88.41 | $7.47 – $321.85 | 508,579 | 326 |
| Boston, MA | $47.20 | $0.00 – $420.77 | 509,112 | 53 |
| Stamford, CT | $39.99 | $0.00 – $6,670 | 510,651 | 8 |
| Ann Arbor, MI | $15.32 | $0.00 – $254.60 | 511,957 | 8 |
| Asheville, NC | $51.15 | $0.00 – $599.08 | 512,413 | 19 |
| Redding, CA | $66.88 | $0.00 – $312.57 | 513,660 | 20 |
| Bangor, ME | $105.08 | $0.00 – $1,240 | 515,120 | 184 |
| Rosedale, MD | $83.70 | $80.80 – $194.23 | 517,192 | 6 |
| Benton Harbor, MI | $16.31 | $4.59 – $66.05 | 521,461 | 3 |
| Taunton, MA | $33.04 | $0.25 – $307.48 | 522,430 | 7 |
| Lake Charles, LA | $41.82 | $13.29 – $124.34 | 535,079 | 19 |
| Anaheim, CA | $41.56 | $0.00 – $93.57 | 539,605 | 17 |
| Kalispell, MT | $13.14 | $0.00 – $109.30 | 544,564 | 7 |
| Wausau, WI | $12.84 | $0.00 – $498.71 | 545,752 | 63 |
| West Milwaukee, WI | $10.19 | $0.00 – $43.75 | 547,055 | 36 |
| Pennsauken, NJ | $72.03 | $0.95 – $109.48 | 549,164 | 5 |
| Ontario, CA | $25.92 | $0.00 – $117.67 | 554,316 | 25 |
| Lexington, NC | $37.79 | $37.54 – $107.07 | 559,581 | 4 |
| Boise, ID | $109.07 | $0.00 – $777.88 | 562,733 | 96 |
| Duluth, MN | $73.03 | $26.59 – $2,514 | 563,750 | 27 |
| Eugene, OR | $94.74 | $0.00 – $5,451 | 563,797 | 378 |
| Frederick, MD | $94.58 | $0.00 – $199.54 | 571,489 | 24 |
| Santa Barbara, CA | $36.49 | $0.00 – $664.41 | 572,745 | 19 |
| Auburn, WA | $18.96 | $0.00 – $136.25 | 573,917 | 89 |
| Windsor, CT | $20.21 | $4.76 – $23.38 | 581,500 | 4 |
| Pueblo, CO | $90.02 | $0.00 – $400.00 | 582,607 | 73 |
| Woonsocket, RI | $28.63 | $0.00 – $337.81 | 586,192 | 14 |
| Valparaiso, IN | $18.37 | $14.91 – $63.99 | 588,414 | 6 |
| Appleton, WI | $11.15 | $0.00 – $148.43 | 589,242 | 72 |
| Saint Louis, MO | $58.36 | $0.00 – $143.31 | 590,079 | 69 |
| New Albany, OH | $16.58 | $16.57 – $72.60 | 590,281 | 2 |
| Springfield, MO | $28.32 | $0.00 – $139.26 | 597,533 | 19 |
| Bennington, VT | $15.54 | $12.24 – $947.35 | 599,637 | 10 |
Cost Components
National averages for each billing code in this procedure category. Sorted by claim volume.
| 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 averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.