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 |
|---|---|---|---|---|
| Franklin, KY | $72.54 | $65.17 – $73.77 | 47,940 | 2 |
| Richfield, MN | $421.70 | $92.67 – $1,951 | 47,979 | 3 |
| Roundhill, KY | $64.64 | $64.64 – $64.64 | 48,165 | 1 |
| Wilburton, OK | $69.43 | $60.70 – $73.09 | 48,166 | 12 |
| Ypsilanti, MI | $143.56 | $0.00 – $230.34 | 48,445 | 5 |
| Chehalis, WA | $55.34 | $0.00 – $258.06 | 48,480 | 64 |
| Manteno, IL | $58.28 | $44.16 – $120.63 | 48,494 | 9 |
| Snow Hill, MD | $71.83 | $69.39 – $71.83 | 48,597 | 2 |
| Dunbar, WV | $90.53 | $52.50 – $124.54 | 48,693 | 3 |
| Kent, OH | $83.63 | $0.00 – $219.17 | 48,795 | 44 |
| East Orange, NJ | $101.32 | $0.00 – $110.69 | 48,801 | 7 |
| Sandusky, OH | $107.73 | $13.02 – $294.28 | 49,283 | 41 |
| Franklin, IN | $322.02 | $322.02 – $322.02 | 49,286 | 1 |
| Caribou, ME | $72.53 | $0.00 – $110.95 | 49,359 | 29 |
| Hillsborough, NC | $53.33 | $49.84 – $120.31 | 49,572 | 2 |
| Cambridge, MD | $79.23 | $48.42 – $122.68 | 49,646 | 8 |
| Jackson, TN | $94.99 | $4.96 – $285.25 | 49,666 | 14 |
| West Springfield, MA | $3.64 | $3.64 – $3.64 | 49,806 | 1 |
| Chester, PA | $366.01 | $366.01 – $366.01 | 49,862 | 1 |
| Lemon Grove, CA | $205.57 | $0.00 – $205.89 | 49,889 | 3 |
| Toms River, NJ | $67.49 | $11.18 – $121.50 | 49,914 | 11 |
| Napa, CA | $190.39 | $0.00 – $222.46 | 50,040 | 17 |
| Los Alamitos, CA | $93.10 | $93.10 – $93.10 | 50,068 | 1 |
| Newark, DE | $168.79 | $0.00 – $255.40 | 50,288 | 5 |
| Dickinson, ND | $31.70 | $15.96 – $554.12 | 50,308 | 12 |
| Elkhorn, WI | $8.03 | $6.76 – $31.34 | 50,372 | 7 |
| Lasalle, IL | $76.38 | $61.62 – $77.57 | 50,547 | 2 |
| Triadelphia, WV | $75.74 | $0.00 – $97.30 | 50,552 | 3 |
| Heavener, OK | $71.09 | $67.66 – $74.26 | 50,574 | 8 |
| Mitchellville, MD | $10.42 | $10.42 – $10.42 | 50,606 | 1 |
| Belleville, IL | $75.87 | $48.77 – $149.82 | 50,623 | 5 |
| Chubbuck, ID | $103.26 | $45.59 – $125.10 | 50,703 | 7 |
| Franklin, NC | $61.52 | $34.93 – $132.45 | 50,708 | 4 |
| Rumford, ME | $80.95 | $49.16 – $163.70 | 50,769 | 15 |
| Bastrop, LA | $214.69 | $0.00 – $215.53 | 50,793 | 4 |
| Linton, IN | $379.80 | $379.80 – $379.80 | 50,794 | 1 |
| Chardon, OH | $37.15 | $7.52 – $181.00 | 50,816 | 30 |
| Findlay, OH | $79.34 | $0.00 – $159.34 | 51,241 | 47 |
| Lake Elsinore, CA | $96.51 | $0.00 – $362.63 | 51,289 | 12 |
| Louisburg, NC | $135.86 | $88.33 – $141.02 | 51,344 | 3 |
| Corpus Christi, TX | $15.97 | $2.67 – $49.95 | 51,610 | 4 |
| Canon City, CO | $120.17 | $0.36 – $554.85 | 51,675 | 17 |
| Safford, AZ | $84.28 | $0.00 – $198.66 | 51,852 | 7 |
| New Lenox, IL | $104.10 | $104.10 – $104.10 | 51,872 | 1 |
| Harvey, IL | $93.16 | $56.50 – $96.38 | 51,898 | 3 |
| Salina, KS | $73.20 | $0.00 – $89.60 | 52,061 | 5 |
| Page, AZ | $47.40 | $18.08 – $219.49 | 52,114 | 7 |
| Oregon City, OR | $77.65 | $0.00 – $239.97 | 52,252 | 73 |
| Windham, ME | $332.58 | $53.86 – $1,218 | 52,256 | 30 |
| Grover Beach, CA | $96.63 | $96.63 – $96.63 | 52,361 | 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.