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 |
|---|---|---|---|---|
| Elizabethtown, NC | $121.22 | $121.22 – $121.22 | 3,921 | 1 |
| Mililani, HI | $13.01 | $13.01 – $13.01 | 3,921 | 1 |
| Winter Haven, FL | $272.03 | $3.53 – $297.32 | 3,926 | 4 |
| Troutdale, OR | $61.12 | $61.12 – $61.12 | 3,938 | 1 |
| Elmont, NY | $19.20 | $0.01 – $204.36 | 3,944 | 7 |
| Madison, CT | $126.11 | $120.71 – $150.12 | 3,946 | 2 |
| Lebanon, VA | $24.67 | $20.06 – $93.14 | 3,963 | 3 |
| Caney, KS | $68.95 | $68.95 – $68.95 | 3,963 | 1 |
| Chippewa Falls, WI | $34.73 | $10.37 – $72.67 | 3,966 | 7 |
| Goodlettsville, TN | $120.95 | $12.43 – $189.25 | 3,966 | 2 |
| Lexington, SC | $43.12 | $21.81 – $43.20 | 3,967 | 2 |
| Mattawamkeag, ME | $83.68 | $83.68 – $83.68 | 3,971 | 1 |
| Bernalillo, NM | $125.59 | $85.44 – $145.81 | 3,977 | 2 |
| Cumberland, RI | $16.68 | $16.36 – $18.93 | 3,979 | 2 |
| Granger, IN | $394.40 | $394.40 – $394.40 | 3,990 | 1 |
| Longwood, FL | $46.48 | $0.00 – $53.16 | 3,994 | 5 |
| Norwell, MA | $97.58 | $35.29 – $98.19 | 3,998 | 3 |
| Cynthiana, KY | $86.50 | $9.82 – $106.93 | 4,003 | 2 |
| Adel, GA | $53.55 | $53.55 – $53.55 | 4,016 | 1 |
| Twinsburg, OH | $38.94 | $37.37 – $137.98 | 4,026 | 2 |
| Naugatuck, CT | $119.81 | $119.81 – $119.81 | 4,035 | 1 |
| Seaside, OR | $21.81 | $0.00 – $79.39 | 4,041 | 7 |
| Cherryfield, ME | $79.85 | $79.85 – $79.85 | 4,042 | 1 |
| Tooele, UT | $103.88 | $21.26 – $656.48 | 4,048 | 8 |
| Lyndhurst, OH | $141.47 | $141.47 – $141.47 | 4,064 | 1 |
| Houma, LA | $54.82 | $19.22 – $127.53 | 4,088 | 5 |
| Falls Church, VA | $184.04 | $20.86 – $207.43 | 4,091 | 3 |
| Ramsey, MN | $68.41 | $68.41 – $68.41 | 4,094 | 1 |
| West Liberty, KY | $26.29 | $26.29 – $26.29 | 4,098 | 1 |
| St. Louis, MO | $0.00 | $0.00 – $0.00 | 4,104 | 1 |
| Billerica, MA | $126.58 | $126.58 – $126.58 | 4,109 | 1 |
| Casper, WY | $109.05 | $27.55 – $159.25 | 4,122 | 11 |
| Fellsmere, FL | $87.94 | $0.00 – $132.61 | 4,124 | 5 |
| Johnston, IA | $0.00 | $0.00 – $0.00 | 4,129 | 1 |
| Yucaipa, CA | $0.01 | $0.00 – $0.20 | 4,136 | 6 |
| Mount Clemens, MI | $123.24 | $123.24 – $123.24 | 4,138 | 1 |
| Wiscasset, ME | $85.44 | $64.49 – $105.22 | 4,147 | 5 |
| Minocqua, WI | $14.31 | $5.75 – $30.59 | 4,150 | 7 |
| Burlington City, NJ | $100.96 | $100.96 – $100.96 | 4,154 | 1 |
| Sandy, OR | $140.11 | $38.40 – $254.05 | 4,155 | 7 |
| Macedonia, OH | $121.92 | $121.45 – $142.31 | 4,158 | 2 |
| Somerville, MA | $55.07 | $22.31 – $339.32 | 4,161 | 6 |
| Crawfordsville, IN | $38.92 | $18.63 – $48.18 | 4,173 | 3 |
| Germantown, TN | $0.89 | $0.89 – $0.89 | 4,174 | 1 |
| Vincennes, IN | $158.28 | $22.22 – $373.45 | 4,175 | 4 |
| San Andreas, CA | $45.16 | $0.00 – $56.74 | 4,177 | 2 |
| Lamont, CA | $143.90 | $60.06 – $159.57 | 4,179 | 2 |
| Great Bend, KS | $38.51 | $0.00 – $72.93 | 4,185 | 3 |
| Liberty, NC | $191.76 | $185.58 – $194.78 | 4,194 | 2 |
| Issaquah, WA | $109.11 | $0.00 – $148.77 | 4,218 | 11 |
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.