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 |
|---|---|---|---|---|
| Newark, MD | $80.78 | $78.01 – $94.81 | 371 | 2 |
| Guilford, IN | $118.91 | $118.91 – $118.91 | 372 | 1 |
| Overpeck, OH | $150.28 | $150.28 – $150.28 | 372 | 1 |
| Ephrata, PA | $22.49 | $17.68 – $26.48 | 373 | 5 |
| Ashburn, VA | $120.67 | $120.67 – $120.67 | 375 | 1 |
| Blanchester, OH | $18.26 | $18.26 – $18.26 | 375 | 1 |
| Lindsay, OK | $55.61 | $55.61 – $55.61 | 375 | 1 |
| The Village, OK | $62.46 | $55.49 – $66.71 | 375 | 2 |
| Union City, CA | $0.89 | $0.00 – $24.00 | 376 | 3 |
| West Lafayette, IN | $62.76 | $62.76 – $62.76 | 376 | 1 |
| Brinkley, AR | $74.33 | $74.33 – $74.33 | 377 | 1 |
| Garden City, MN | $3,196 | $3,196 – $3,196 | 377 | 1 |
| Mccurtain, OK | $65.19 | $65.19 – $65.19 | 377 | 1 |
| Dublin, GA | $13.54 | $13.54 – $13.54 | 378 | 1 |
| Pearl River, NY | $8.82 | $8.82 – $8.82 | 379 | 1 |
| Cuthbert, GA | $0.00 | $0.00 – $0.00 | 379 | 1 |
| Ravensdale, WA | $0.00 | $0.00 – $0.00 | 379 | 1 |
| Highland Park, NJ | $2.27 | $2.27 – $2.27 | 380 | 1 |
| Groveton, NH | $94.44 | $94.44 – $94.44 | 380 | 1 |
| Williamsport, PA | $36.96 | $1.26 – $93.18 | 381 | 2 |
| Carbondale, CO | $0.00 | $0.00 – $0.00 | 381 | 2 |
| Grayling, MI | $34.60 | $0.00 – $61.31 | 381 | 2 |
| Phillips, WI | $86.99 | $57.44 – $93.71 | 381 | 3 |
| Ojai, CA | $155.96 | $155.96 – $155.96 | 382 | 1 |
| Spring Park, MN | $1,622 | $1,622 – $1,622 | 382 | 1 |
| Oxford, AR | $62.06 | $33.37 – $71.69 | 382 | 2 |
| Reston, VA | $72.07 | $69.77 – $83.31 | 383 | 2 |
| Lahaina, HI | $23.81 | $23.76 – $24.00 | 383 | 2 |
| Albany, KY | $35.88 | $35.88 – $35.88 | 384 | 1 |
| Bowler, WI | $83.88 | $83.88 – $83.88 | 384 | 1 |
| Ft Washington, MD | $211.48 | $71.94 – $402.70 | 384 | 2 |
| Chaplin, KY | $83.01 | $83.01 – $83.01 | 384 | 1 |
| New Gloucester, ME | $78.71 | $78.71 – $78.71 | 385 | 1 |
| Burgaw, NC | $120.26 | $111.60 – $120.83 | 386 | 2 |
| Luther, OK | $67.83 | $67.83 – $67.83 | 386 | 1 |
| Branson, MO | $0.00 | $0.00 – $0.00 | 388 | 1 |
| Crown Point, NY | $38.45 | $38.45 – $38.45 | 388 | 1 |
| Duncansville, PA | $452.12 | $452.12 – $452.12 | 389 | 1 |
| Pomeroy, WA | $0.00 | $0.00 – $0.00 | 390 | 1 |
| Buena Park, CA | $2.67 | $0.00 – $9.59 | 392 | 5 |
| Venice, FL | $152.12 | $152.12 – $152.12 | 394 | 1 |
| Wayne, ME | $76.43 | $76.43 – $76.43 | 395 | 1 |
| West Windsor, NJ | $14.71 | $14.71 – $14.71 | 396 | 1 |
| Hot Springs, MT | $90.28 | $90.28 – $90.28 | 397 | 1 |
| Lakeport, CA | $80.78 | $80.78 – $80.78 | 398 | 1 |
| Trussville, AL | $70.76 | $49.92 – $286.97 | 398 | 2 |
| Morton, MN | $248.65 | $248.65 – $248.65 | 398 | 1 |
| Green Brook, NJ | $11.24 | $11.24 – $11.24 | 399 | 1 |
| Haddon Heights, NJ | $0.19 | $0.00 – $0.25 | 399 | 2 |
| West Richland, WA | $60.86 | $60.86 – $60.86 | 399 | 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.