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 |
|---|---|---|---|---|
| Castle Rock, WA | $15.63 | $11.64 – $120.62 | 27,608 | 8 |
| Lawrenceville, IL | $73.65 | $54.05 – $73.87 | 27,669 | 2 |
| Woodland, CA | $73.40 | $3.00 – $83.49 | 27,698 | 4 |
| Oakdale, MN | $256.47 | $7.49 – $1,957 | 27,702 | 11 |
| Normal, IL | $93.11 | $78.87 – $93.80 | 27,719 | 4 |
| Windsor, CO | $842.51 | $162.40 – $906.83 | 27,899 | 4 |
| Westerville, OH | $122.71 | $13.88 – $380.80 | 27,925 | 24 |
| Wheeling, IL | $91.79 | $41.88 – $92.49 | 28,282 | 2 |
| Wauseon, OH | $175.56 | $34.25 – $206.59 | 28,307 | 8 |
| Mattoon, IL | $87.33 | $44.56 – $128.72 | 28,376 | 5 |
| Helena, MT | $84.39 | $0.00 – $336.21 | 28,409 | 10 |
| New Lexington, OH | $122.70 | $18.91 – $233.78 | 28,422 | 30 |
| Prague, OK | $45.91 | $0.00 – $69.44 | 28,422 | 7 |
| Lake Worth, FL | $24.61 | $0.00 – $56.17 | 28,486 | 8 |
| Pontiac, IL | $91.63 | $53.79 – $93.97 | 28,490 | 2 |
| Nancy, KY | $47.61 | $0.00 – $69.63 | 28,558 | 5 |
| Wewoka, OK | $52.94 | $40.92 – $65.23 | 28,586 | 6 |
| Somerton, AZ | $13.94 | $12.07 – $72.24 | 28,598 | 4 |
| Ontario, OR | $15.89 | $0.00 – $151.11 | 28,612 | 36 |
| Ponca City, OK | $82.90 | $0.00 – $521.22 | 28,664 | 51 |
| Petersburg, WV | $98.26 | $56.33 – $115.21 | 28,668 | 2 |
| Camden, SC | $42.11 | $19.27 – $75.90 | 28,676 | 3 |
| Fairview Heights, IL | $142.91 | $105.08 – $365.73 | 28,689 | 2 |
| Waxhaw, NC | $46.43 | $46.43 – $46.43 | 28,761 | 1 |
| Boulder, CO | $33.86 | $0.00 – $163.16 | 28,904 | 20 |
| Merrionette Park, IL | $99.67 | $99.67 – $99.67 | 28,923 | 1 |
| Rush City, MN | $85.99 | $85.99 – $85.99 | 28,957 | 1 |
| Mendota Heights, MN | $122.40 | $122.40 – $122.40 | 29,006 | 1 |
| Conway, SC | $68.50 | $18.91 – $76.08 | 29,043 | 4 |
| Mount Holly, NJ | $82.24 | $0.00 – $109.48 | 29,080 | 4 |
| Oroville, CA | $75.10 | $65.25 – $253.23 | 29,122 | 4 |
| Monticello, AR | $66.33 | $0.00 – $109.20 | 29,128 | 14 |
| Baldwin Park, CA | $86.28 | $0.00 – $98.24 | 29,195 | 5 |
| Brooklyn, MD | $82.89 | $82.66 – $160.00 | 29,251 | 2 |
| Barre, VT | $62.60 | $6.31 – $90.37 | 29,328 | 4 |
| Peebles, OH | $115.55 | $19.17 – $118.99 | 29,634 | 3 |
| Leonardtown, MD | $99.09 | $77.36 – $99.11 | 29,709 | 2 |
| Jasper, AL | $105.29 | $56.46 – $256.34 | 29,716 | 2 |
| Barling, AR | $76.21 | $0.00 – $86.26 | 29,719 | 5 |
| Chesapeake, WV | $71.75 | $71.75 – $71.75 | 29,751 | 1 |
| Sherman Oaks, CA | $94.74 | $0.00 – $95.55 | 29,807 | 4 |
| Mt Pleasant, WI | $11.73 | $11.73 – $11.73 | 29,822 | 1 |
| Trenton, MO | $0.00 | $0.00 – $0.00 | 29,839 | 9 |
| Lehigh Acres, FL | $54.39 | $0.00 – $62.31 | 29,868 | 3 |
| Guntersville, AL | $82.41 | $47.62 – $82.57 | 29,874 | 2 |
| Anderson, IN | $334.49 | $30.42 – $416.46 | 30,085 | 10 |
| Cheverly, MD | $75.04 | $57.50 – $301.27 | 30,162 | 5 |
| Maplewood, MN | $573.40 | $62.29 – $2,992 | 30,200 | 4 |
| Siletz, OR | $109.75 | $83.09 – $325.94 | 30,326 | 6 |
| Davenport, IA | $17.02 | $0.00 – $74.39 | 30,411 | 9 |
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.