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 |
|---|---|---|---|---|
| Wautoma, WI | $22.59 | $13.57 – $34.89 | 2,805 | 6 |
| Port Chester, NY | $123.37 | $26.00 – $134.54 | 2,807 | 2 |
| Tewksbury, MA | $283.51 | $283.51 – $283.51 | 2,810 | 1 |
| Otisfield, ME | $79.69 | $79.69 – $79.69 | 2,813 | 1 |
| South Bristol, ME | $71.05 | $71.05 – $71.05 | 2,817 | 1 |
| Easley, SC | $101.57 | $23.20 – $101.93 | 2,823 | 2 |
| Fenton, MO | $0.69 | $0.00 – $10.88 | 2,827 | 2 |
| Mayer, AZ | $260.70 | $260.70 – $260.70 | 2,831 | 1 |
| Mooresville, NC | $12.80 | $11.13 – $40.83 | 2,834 | 3 |
| Apopka, FL | $0.37 | $0.00 – $5.05 | 2,835 | 3 |
| Fairfax, MN | $71.77 | $71.77 – $71.77 | 2,841 | 1 |
| Union, OH | $75.56 | $75.56 – $75.56 | 2,842 | 1 |
| Selma, CA | $53.38 | $53.38 – $53.38 | 2,843 | 1 |
| Monmouth, IL | $87.54 | $58.78 – $91.55 | 2,849 | 2 |
| Greer, SC | $9.04 | $8.21 – $24.72 | 2,859 | 9 |
| Vermilion, OH | $22.81 | $22.81 – $22.81 | 2,860 | 1 |
| Ashland, WI | $42.12 | $6.17 – $117.74 | 2,863 | 7 |
| Greenwood, MS | $9.98 | $9.98 – $9.98 | 2,873 | 1 |
| Lebanon, PA | $43.75 | $0.00 – $476.98 | 2,875 | 3 |
| Montville, NJ | $113.21 | $113.21 – $113.21 | 2,877 | 1 |
| Mountain Home, AR | $84.50 | $1.65 – $91.05 | 2,882 | 3 |
| Pierre, SD | $43.57 | $43.33 – $60.25 | 2,882 | 2 |
| Onamia, MN | $480.52 | $471.97 – $536.96 | 2,882 | 2 |
| Poulsbo, WA | $53.33 | $0.00 – $104.04 | 2,888 | 12 |
| Marshfield, WI | $20.77 | $0.00 – $408.70 | 2,889 | 6 |
| Lakewood Ranch, FL | $17.11 | $17.11 – $17.11 | 2,895 | 1 |
| Clarinda, IA | $88.77 | $88.77 – $88.77 | 2,897 | 1 |
| Ankeny, IA | $76.70 | $76.70 – $76.70 | 2,903 | 1 |
| South San Francisco, CA | $45.56 | $0.00 – $100.20 | 2,903 | 3 |
| Andover, KS | $86.04 | $0.00 – $100.01 | 2,906 | 2 |
| Sparta, TN | $88.43 | $88.43 – $88.43 | 2,907 | 1 |
| Cassopolis, MI | $54.84 | $8.13 – $55.93 | 2,907 | 2 |
| N Hollywood, CA | $0.03 | $0.03 – $0.03 | 2,907 | 1 |
| Southern Pines, NC | $185.25 | $185.25 – $185.25 | 2,908 | 1 |
| Palmyra, ME | $81.12 | $81.12 – $81.12 | 2,914 | 1 |
| Fort Drum, NY | $68.66 | $23.41 – $172.01 | 2,917 | 3 |
| Elkin, NC | $114.51 | $114.51 – $114.51 | 2,928 | 1 |
| Bentonville, AR | $53.26 | $0.00 – $107.75 | 2,931 | 4 |
| Highland, UT | $117.59 | $115.52 – $140.21 | 2,932 | 2 |
| Suquamish, WA | $75.21 | $0.01 – $76.35 | 2,939 | 2 |
| Sebastian, FL | $103.18 | $0.00 – $134.73 | 2,945 | 5 |
| Kansas, OK | $344.73 | $0.00 – $676.56 | 2,952 | 5 |
| Amelia, OH | $26.65 | $0.00 – $111.12 | 2,953 | 4 |
| Monroe, WI | $28.63 | $1.65 – $30.35 | 2,955 | 3 |
| Burnsville, NC | $58.69 | $58.69 – $58.69 | 2,956 | 1 |
| Mars Hill, ME | $89.46 | $0.00 – $107.15 | 2,957 | 4 |
| Jackson Hts, NY | $0.59 | $0.59 – $0.59 | 2,962 | 1 |
| Dryden, NY | $50.69 | $50.69 – $50.69 | 2,968 | 1 |
| Enterprise, OR | $29.59 | $0.00 – $41.66 | 2,972 | 5 |
| Garfield Hts, OH | $114.47 | $40.53 – $130.42 | 2,973 | 7 |
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.