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 |
|---|---|---|---|---|
| Lakeside, AZ | $79.26 | $35.14 – $79.88 | 1,150 | 2 |
| Milton, WA | $45.17 | $9.65 – $114.20 | 1,151 | 2 |
| Fairfax, VT | $78.55 | $78.55 – $78.55 | 1,163 | 1 |
| Brush Prairie, WA | $76.45 | $76.45 – $76.45 | 1,163 | 1 |
| Fryeburg, ME | $91.30 | $91.30 – $91.30 | 1,164 | 1 |
| Jonesville, VA | $302.88 | $105.08 – $335.49 | 1,173 | 2 |
| Barley, ID | $53.84 | $53.84 – $53.84 | 1,176 | 1 |
| Owensville, IN | $346.03 | $346.03 – $346.03 | 1,182 | 1 |
| South Hill, VA | $173.61 | $173.61 – $173.61 | 1,183 | 1 |
| Wauwatosa, WI | $93.24 | $7.15 – $151.74 | 1,185 | 13 |
| Moberly, MO | $0.00 | $0.00 – $0.00 | 1,188 | 1 |
| Roslyn Heights, NY | $82.19 | $82.19 – $82.19 | 1,192 | 1 |
| Decherd, TN | $87.30 | $87.30 – $87.30 | 1,194 | 1 |
| Clatskanie, OR | $18.69 | $5.15 – $29.46 | 1,196 | 2 |
| Valley Cottage, NY | $45.65 | $31.73 – $51.34 | 1,206 | 2 |
| Two Rivers, WI | $12.46 | $12.46 – $12.46 | 1,208 | 1 |
| Pigeon, MI | $66.88 | $66.88 – $66.88 | 1,208 | 1 |
| Deerfield, IL | $33.02 | $32.89 – $35.99 | 1,211 | 2 |
| Palm Coast, FL | $93.57 | $46.61 – $98.22 | 1,212 | 2 |
| Lakewood, CA | $0.00 | $0.00 – $0.00 | 1,212 | 2 |
| Rancho Santa Margarita, CA | $57.77 | $0.00 – $66.59 | 1,215 | 2 |
| Elmhurts, NY | $0.04 | $0.04 – $0.04 | 1,215 | 1 |
| Chesterville, ME | $74.80 | $74.80 – $74.80 | 1,217 | 1 |
| Alhambra, CA | $1.11 | $0.00 – $1.75 | 1,218 | 4 |
| Gardomer, ME | $76.08 | $76.08 – $76.08 | 1,219 | 1 |
| Jamestown, ND | $79.64 | $39.75 – $150.49 | 1,220 | 12 |
| Hana, HI | $0.03 | $0.03 – $0.03 | 1,223 | 1 |
| Fruitland, ID | $107.81 | $96.79 – $117.21 | 1,227 | 2 |
| Olivia, NC | $15.79 | $15.79 – $15.79 | 1,230 | 1 |
| Concord Township, OH | $49.45 | $42.79 – $115.31 | 1,231 | 2 |
| Hickman, NE | $49.89 | $49.89 – $49.89 | 1,232 | 1 |
| Fayette, ME | $79.46 | $79.46 – $79.46 | 1,234 | 1 |
| Wellington, OH | $147.79 | $147.79 – $147.79 | 1,237 | 1 |
| Saint Albans, NY | $3.62 | $0.53 – $13.45 | 1,237 | 2 |
| Montesano, WA | $116.90 | $109.19 – $135.01 | 1,240 | 3 |
| Peggs, OK | $57.14 | $57.14 – $57.14 | 1,243 | 1 |
| Mt. Gilead, OH | $73.18 | $65.71 – $74.95 | 1,244 | 2 |
| Brevard, NC | $26.75 | $26.75 – $26.75 | 1,256 | 1 |
| Mountain Home, ID | $66.11 | $0.00 – $163.09 | 1,257 | 4 |
| Westlake Village, CA | $0.00 | $0.00 – $0.00 | 1,260 | 2 |
| Waupaca, WI | $8.59 | $7.24 – $9.26 | 1,261 | 2 |
| Graham, WA | $119.49 | $14.61 – $142.86 | 1,261 | 8 |
| Cherokee, OK | $67.39 | $67.39 – $67.39 | 1,263 | 1 |
| Oakland Gardens, NY | $0.18 | $0.00 – $0.34 | 1,264 | 2 |
| Wadena, MN | $918.54 | $100.39 – $999.28 | 1,264 | 3 |
| Las Vegas, NM | $151.44 | $58.32 – $173.84 | 1,268 | 3 |
| University Park, PA | $29.27 | $29.27 – $29.27 | 1,268 | 1 |
| Newberry, SC | $65.13 | $0.65 – $95.43 | 1,270 | 2 |
| Zelienople, PA | $68.54 | $13.89 – $82.12 | 1,271 | 2 |
| Baldwinville, MA | $422.93 | $422.93 – $422.93 | 1,272 | 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.