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 |
|---|---|---|---|---|
| Brattleboro, VT | $18.57 | $16.76 – $1,359 | 3,346,603 | 20 |
| Detroit, MI | $28.79 | $0.11 – $306.37 | 3,445,158 | 50 |
| San Francisco, CA | $24.87 | $0.00 – $916.52 | 3,627,413 | 86 |
| Westfield, MA | $13.90 | $3.94 – $55.83 | 4,149,253 | 6 |
| Sacramento, CA | $25.46 | $0.00 – $509.00 | 4,355,222 | 74 |
| Fresno, CA | $27.33 | $0.00 – $226.99 | 4,413,563 | 48 |
| Seattle, WA | $5.11 | $0.00 – $551.37 | 4,506,327 | 729 |
| Minneapolis, MN | $105.30 | $0.00 – $2,266 | 4,553,952 | 107 |
| Philadelphia, PA | $57.23 | $0.00 – $5,867 | 5,131,687 | 140 |
| New Haven, CT | $16.20 | $0.00 – $1,344 | 5,439,085 | 50 |
| Tucson, AZ | $40.42 | $0.00 – $5,275 | 5,677,967 | 267 |
| Albuquerque, NM | $34.24 | $0.00 – $345.96 | 5,929,577 | 285 |
| Bronx, NY | $38.59 | $0.00 – $275.00 | 6,144,578 | 254 |
| Worcester, MA | $21.52 | $0.00 – $5,682 | 6,777,067 | 53 |
| Portland, OR | $37.53 | $0.00 – $2,217 | 6,780,611 | 1329 |
| Baltimore, MD | $107.97 | $0.00 – $319.54 | 7,464,932 | 477 |
| Springfield, MA | $20.44 | $0.00 – $290.85 | 8,386,620 | 42 |
| Phoenix, AZ | $94.34 | $0.00 – $5,045 | 10,076,493 | 688 |
| Hartford, CT | $14.18 | $0.00 – $2,412 | 12,612,724 | 41 |
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.