Skip to content
Based on public Medicaid payment data.

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 β€” 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
South Paris, ME $98.85 $54.77 – $108.65 5,499 5
Yarmouth, ME $79.14 $48.11 – $96.35 5,516 7
Brandon, FL $18.45 $0.00 – $71.43 5,518 9
Holden, ME $77.72 $0.00 – $78.08 5,532 2
Lake Crystal, MN $1,888 $1,888 – $1,888 5,534 1
Sterling, IL $85.71 $67.23 – $108.70 5,558 3
Colonial Heights, VA $285.63 $224.68 – $294.25 5,558 2
Des Moines, WA $10.23 $0.00 – $23.66 5,568 12
Dillon, SC $64.89 $5.17 – $69.38 5,592 3
Temple Hills, MD $76.40 $71.99 – $76.48 5,607 2
Fort Thomas, KY $16.34 $16.34 – $16.34 5,608 1
Plymouth Meeting, PA $294.60 $294.60 – $294.60 5,613 1
Fairfield, ME $76.66 $62.40 – $82.93 5,625 4
Leipsic, OH $167.61 $167.61 – $167.61 5,638 1
Calumet, MI $95.17 $39.37 – $106.62 5,648 2
Tonawanda, NY $188.70 $188.70 – $188.70 5,657 1
Madison, TN $74.79 $21.71 – $95.63 5,668 3
Garrett, KY $18.14 $18.14 – $18.14 5,691 1
Wisconsin Rapids, WI $43.97 $0.00 – $55.11 5,705 9
Kennebunkport, ME $118.70 $118.70 – $118.70 5,712 1
Crowley, LA $69.85 $1.83 – $112.03 5,713 5
Springfield, GA $71.56 $71.56 – $71.56 5,732 1
Central Point, OR $54.32 $0.00 – $94.33 5,739 14
Latham, NY $59.71 $58.52 – $98.51 5,758 2
Eden, NY $753.74 $753.74 – $753.74 5,758 1
Sayville, NY $125.51 $125.51 – $125.51 5,760 1
Lacey, WA $81.50 $0.00 – $296.39 5,772 15
Minden, LA $65.49 $8.43 – $79.93 5,776 5
Opelousas, LA $14.64 $0.00 – $25.42 5,789 6
Colmar, PA $94.24 $94.24 – $94.24 5,795 1
Belleville, NJ $0.00 $0.00 – $0.00 5,798 1
Fishers, IN $180.03 $0.00 – $219.85 5,810 4
Mason City, IA $9.60 $9.60 – $9.60 5,813 1
North Miami Beach, FL $32.74 $11.73 – $67.94 5,818 6
Princeton, KY $105.18 $24.41 – $107.60 5,825 2
Austin, TX $22.32 $0.00 – $131.48 5,826 9
Chouteau, OK $60.45 $0.00 – $72.23 5,827 5
West Bend, WI $51.20 $8.98 – $157.92 5,885 8
Walla Walla, WA $9.04 $0.00 – $67.14 5,898 18
Sugar City, ID $87.80 $87.65 – $103.44 5,908 2
North Lima, OH $110.90 $33.01 – $200.35 5,915 4
Sun Prairie, WI $15.34 $10.89 – $42.66 5,919 4
Oologah, OK $53.70 $0.00 – $69.51 5,923 6
Cumberland, ME $96.42 $56.92 – $97.35 5,926 2
Nyack, NY $63.16 $62.87 – $204.89 5,938 2
Sparta, NJ $31.01 $31.01 – $31.01 5,962 1
North Mankato, MN $93.53 $44.18 – $147.51 5,981 4
Hayward, WI $17.61 $6.82 – $47.42 5,985 7
Talbott, TN $13.10 $11.45 – $56.97 5,995 2
Stone Mountain, GA $88.95 $88.95 – $88.95 5,998 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.