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 |
|---|---|---|---|---|
| Leroy, MI | $6.41 | $6.41 – $6.41 | 335 | 1 |
| Encino, CA | $0.00 | $0.00 – $0.00 | 336 | 2 |
| Mccleary, WA | $65.95 | $65.95 – $65.95 | 336 | 1 |
| South Toms River, NJ | $109.48 | $109.48 – $109.48 | 336 | 1 |
| Lakeside, CA | $0.00 | $0.00 – $0.00 | 337 | 5 |
| Clayton, GA | $291.60 | $291.60 – $291.60 | 337 | 1 |
| Milton, VT | $53.86 | $53.86 – $53.86 | 337 | 1 |
| Riverbank, CA | $19.03 | $19.03 – $19.03 | 337 | 1 |
| Roseville, OH | $29.17 | $29.17 – $29.17 | 337 | 1 |
| Little Rock Afb, AR | $74.26 | $74.26 – $74.26 | 337 | 1 |
| Dorchester, MA | $65.39 | $0.00 – $349.19 | 338 | 4 |
| Lenoir City, TN | $8.23 | $8.23 – $8.23 | 339 | 1 |
| Spring Valley, CA | $26.77 | $26.77 – $26.77 | 340 | 1 |
| Uniontown, OH | $100.15 | $0.00 – $148.44 | 341 | 4 |
| Mena, AR | $76.54 | $76.54 – $76.54 | 341 | 1 |
| Sparta, IL | $76.89 | $71.64 – $84.91 | 341 | 2 |
| Stanford, KY | $5.13 | $5.13 – $5.13 | 342 | 1 |
| Gulfport, MS | $20.98 | $18.42 – $37.51 | 343 | 2 |
| Shenandoah, TX | $267.27 | $267.27 – $267.27 | 343 | 1 |
| Wilmington, MA | $132.00 | $132.00 – $132.00 | 346 | 1 |
| West Middlesex, PA | $34.20 | $34.20 – $34.20 | 346 | 1 |
| Lakeview, NC | $174.12 | $174.12 – $174.12 | 346 | 1 |
| Spencer, IA | $39.26 | $39.26 – $39.26 | 347 | 1 |
| Farrell, PA | $6.40 | $6.40 – $6.40 | 348 | 1 |
| Englewood, TN | $11.35 | $11.35 – $11.35 | 348 | 1 |
| Westtown, NY | $37.45 | $37.45 – $37.45 | 348 | 1 |
| Akwesasne, NY | $579.72 | $579.72 – $579.72 | 349 | 1 |
| Lockland, OH | $46.52 | $46.52 – $46.52 | 352 | 1 |
| Pleasant Grove, UT | $47.20 | $47.20 – $47.20 | 353 | 1 |
| Beattyville, KY | $0.00 | $0.00 – $0.00 | 353 | 1 |
| West Branch, MI | $0.72 | $0.72 – $0.72 | 353 | 1 |
| Manahawkin, NJ | $88.45 | $0.00 – $109.48 | 354 | 2 |
| Johnstown, CO | $9.08 | $0.00 – $11.64 | 354 | 4 |
| East Cleveland, OH | $64.49 | $64.49 – $64.49 | 354 | 1 |
| Wyckoff, NJ | $97.84 | $97.84 – $97.84 | 355 | 1 |
| Wells, ME | $75.44 | $75.44 – $75.44 | 358 | 1 |
| Palmyra, NJ | $58.10 | $58.10 – $58.10 | 358 | 1 |
| Oradel, NJ | $42.01 | $42.01 – $42.01 | 360 | 1 |
| Pasadena, TX | $0.00 | $0.00 – $0.00 | 361 | 2 |
| Fall City, WA | $0.00 | $0.00 – $0.00 | 361 | 1 |
| Gilroy, CA | $50.76 | $0.00 – $57.56 | 364 | 2 |
| Courtland, AL | $9.56 | $9.56 – $9.56 | 364 | 1 |
| Los Altos, CA | $9.88 | $9.88 – $9.88 | 365 | 1 |
| Dover, FL | $2.41 | $2.41 – $2.41 | 365 | 1 |
| Foster City, CA | $10.27 | $10.27 – $10.27 | 367 | 1 |
| Cutler Bay, FL | $14.31 | $2.11 – $22.00 | 368 | 3 |
| Lithonia, GA | $117.44 | $116.63 – $134.19 | 368 | 2 |
| Quakertown, PA | $174.24 | $18.50 – $2,293 | 369 | 5 |
| Ruskin, FL | $0.08 | $0.08 – $0.08 | 369 | 1 |
| Norristown, PA | $6,576 | $6,576 – $6,576 | 370 | 1 |
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.