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 |
|---|---|---|---|---|
| Florence, SC | $71.91 | $11.92 – $101.37 | 35,955 | 18 |
| Surprise, AZ | $256.25 | $0.00 – $3,128 | 36,008 | 14 |
| North Charleston, SC | $76.57 | $68.83 – $96.37 | 36,021 | 3 |
| Piketon, OH | $93.89 | $18.93 – $182.81 | 36,030 | 32 |
| Pewaukee, WI | $6.68 | $5.55 – $35.53 | 36,067 | 4 |
| Red Bank, NJ | $13.87 | $0.00 – $634.22 | 36,152 | 6 |
| Marquette, MI | $122.35 | $20.28 – $393.19 | 36,233 | 7 |
| Duncan, OK | $64.45 | $24.79 – $71.36 | 36,272 | 23 |
| Lafayette, IN | $257.79 | $1.49 – $334.10 | 36,572 | 6 |
| Evanston, IL | $79.83 | $17.90 – $110.16 | 36,611 | 7 |
| West Hollywood, CA | $85.34 | $0.00 – $88.21 | 36,631 | 5 |
| Paynesville, MN | $96.85 | $69.28 – $99.52 | 36,817 | 2 |
| Passaic, NJ | $88.54 | $0.00 – $110.43 | 36,889 | 7 |
| Newhall, CA | $16.08 | $0.00 – $16.38 | 37,047 | 2 |
| Crystal, MN | $92.42 | $92.42 – $92.42 | 37,058 | 1 |
| Northridge, CA | $81.81 | $0.00 – $82.12 | 37,085 | 2 |
| Lake Villa, IL | $67.93 | $49.54 – $82.32 | 37,090 | 4 |
| Owasso, OK | $64.44 | $0.00 – $71.52 | 37,118 | 23 |
| Queensbury, NY | $57.73 | $57.73 – $57.73 | 37,119 | 1 |
| Vinton, OH | $95.74 | $34.54 – $156.72 | 37,186 | 18 |
| Paramus, NJ | $83.43 | $0.00 – $116.96 | 37,307 | 10 |
| Weatherford, OK | $57.62 | $0.00 – $72.04 | 37,343 | 24 |
| Laguna Hills, CA | $90.88 | $0.00 – $257.17 | 37,423 | 6 |
| Crown Point, IN | $320.89 | $9.82 – $335.97 | 37,522 | 3 |
| Yucca Valley, CA | $41.30 | $0.00 – $394.52 | 37,595 | 14 |
| Vinita, OK | $47.20 | $0.00 – $647.72 | 37,599 | 37 |
| Anderson, SC | $78.95 | $23.29 – $127.25 | 37,639 | 5 |
| Weirton, WV | $96.15 | $20.80 – $141.14 | 37,705 | 4 |
| Willisburg, KY | $39.66 | $26.09 – $92.11 | 38,073 | 4 |
| Edgewood, KY | $352.78 | $75.15 – $355.86 | 38,242 | 2 |
| Shelton, WA | $37.49 | $0.00 – $279.47 | 38,534 | 36 |
| Westmont, IL | $96.17 | $42.35 – $97.51 | 38,609 | 3 |
| Idabel, OK | $65.11 | $48.53 – $75.75 | 38,615 | 13 |
| North Olmsted, OH | $90.20 | $30.56 – $137.69 | 38,806 | 10 |
| Broomfield, CO | $223.38 | $17.83 – $459.55 | 38,915 | 10 |
| Georgetown, KY | $86.53 | $16.58 – $192.78 | 39,052 | 15 |
| Eldorado, IL | $82.01 | $54.43 – $83.43 | 39,218 | 2 |
| Spartanburg, SC | $64.08 | $21.10 – $100.62 | 39,284 | 15 |
| Airmont, NY | $117.10 | $117.10 – $117.10 | 39,320 | 1 |
| Federal Way, WA | $26.32 | $0.00 – $171.20 | 39,487 | 44 |
| East Grand Forks, MN | $550.85 | $81.76 – $804.32 | 39,746 | 4 |
| Mansfield Center, CT | $139.29 | $92.09 – $454.65 | 39,832 | 4 |
| Quincy, IL | $75.79 | $0.00 – $102.37 | 39,899 | 10 |
| Keansburg, NJ | $86.78 | $17.27 – $112.72 | 39,941 | 2 |
| Franklin Park, IL | $84.73 | $78.19 – $85.21 | 39,956 | 2 |
| Loretto, MN | $429.96 | $429.96 – $429.96 | 40,044 | 1 |
| Wagoner, OK | $54.76 | $0.00 – $619.35 | 40,050 | 30 |
| Dobbs Ferry, NY | $107.38 | $89.52 – $114.82 | 40,112 | 2 |
| Bridgton, ME | $81.22 | $62.52 – $118.25 | 40,130 | 24 |
| Ellicott City, MD | $81.89 | $40.58 – $184.12 | 40,192 | 4 |
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.