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 |
|---|---|---|---|---|
| Clifton Springs, NY | $125.63 | $51.36 – $125.68 | 166,246 | 2 |
| Muskogee, OK | $68.32 | $0.00 – $640.00 | 167,111 | 107 |
| Saint Charles, MO | $90.50 | $0.00 – $166.94 | 167,366 | 6 |
| Clayton, NC | $44.30 | $21.12 – $163.80 | 167,971 | 3 |
| Beaver, WV | $96.40 | $0.00 – $148.61 | 168,101 | 4 |
| Jacksonville, NC | $61.38 | $12.41 – $139.75 | 168,123 | 6 |
| Nashua, NH | $143.89 | $0.00 – $224.70 | 168,205 | 30 |
| Ashtabula, OH | $115.89 | $18.64 – $264.01 | 168,224 | 107 |
| Hayes, VA | $9.58 | $8.92 – $135.71 | 168,873 | 2 |
| Westhampton Beach, NY | $64.96 | $64.96 – $64.96 | 169,105 | 1 |
| Longmont, CO | $22.73 | $0.00 – $255.42 | 169,528 | 20 |
| Elk Grove Village, IL | $98.36 | $98.36 – $98.36 | 169,824 | 1 |
| Middletown, NY | $67.54 | $0.00 – $182.61 | 169,986 | 10 |
| Jersey City, NJ | $99.46 | $0.00 – $236.73 | 170,607 | 7 |
| Cape Girardeau, MO | $65.14 | $6.06 – $128.36 | 170,944 | 5 |
| Hickory, NC | $81.54 | $0.00 – $164.85 | 172,184 | 8 |
| Brainerd, MN | $189.13 | $13.27 – $7,216 | 172,273 | 10 |
| Saint Joseph, MO | $5.50 | $0.00 – $87.84 | 172,736 | 4 |
| Williamsburg, VA | $62.47 | $9.62 – $329.37 | 173,307 | 18 |
| Saint Helens, OR | $51.20 | $0.00 – $791.31 | 174,611 | 82 |
| Owensboro, KY | $127.62 | $0.00 – $386.06 | 174,640 | 30 |
| Cape Coral, FL | $14.60 | $14.56 – $32.16 | 174,899 | 2 |
| Albion, NY | $29.48 | $29.48 – $29.48 | 175,045 | 1 |
| Watertown, NY | $45.55 | $18.52 – $68.26 | 175,047 | 4 |
| Essex, MD | $85.36 | $70.05 – $221.40 | 175,690 | 8 |
| Lexington, MA | $51.02 | $50.45 – $123.20 | 176,126 | 3 |
| West Sacramento, CA | $25.97 | $0.00 – $179.63 | 176,464 | 9 |
| Moraine, OH | $45.39 | $12.84 – $285.47 | 176,640 | 35 |
| Peoria, IL | $89.87 | $22.55 – $105.96 | 177,429 | 17 |
| Chesapeake, OH | $86.33 | $13.39 – $148.26 | 177,646 | 134 |
| Reno, NV | $31.00 | $0.00 – $400.94 | 177,890 | 119 |
| San Marcos, CA | $56.90 | $0.00 – $267.26 | 179,672 | 12 |
| Santa Fe Springs, CA | $86.75 | $0.00 – $137.09 | 179,831 | 5 |
| Cumberland, MD | $66.34 | $2.79 – $164.59 | 180,064 | 11 |
| Shawnee, OK | $60.39 | $0.00 – $71.91 | 181,175 | 106 |
| Fairfax, VA | $261.43 | $0.00 – $299.50 | 181,624 | 11 |
| Bothell, WA | $13.67 | $0.00 – $153.53 | 182,070 | 17 |
| Rosedale, NY | $10.93 | $0.00 – $34.31 | 182,407 | 4 |
| Saint Albans, WV | $93.40 | $0.00 – $93.48 | 183,078 | 3 |
| Antlers, OK | $69.30 | $25.14 – $74.23 | 183,666 | 47 |
| Dixon, IL | $82.00 | $53.72 – $83.02 | 184,023 | 2 |
| Statesville, NC | $97.78 | $21.24 – $144.99 | 184,156 | 6 |
| Goldsboro, NC | $83.24 | $35.99 – $156.95 | 184,624 | 9 |
| Wytheville, VA | $320.19 | $21.17 – $320.41 | 185,710 | 3 |
| Saint Cloud, MN | $106.39 | $13.74 – $1,303 | 186,372 | 19 |
| Memphis, TN | $62.85 | $0.00 – $275.00 | 186,574 | 45 |
| Lorain, OH | $132.64 | $0.00 – $205.72 | 187,034 | 99 |
| Franklin, NH | $10.40 | $1.88 – $132.21 | 187,571 | 6 |
| Rehoboth Beach, DE | $13.44 | $13.42 – $16.17 | 187,608 | 2 |
| Roslindale, MA | $56.88 | $56.88 – $56.88 | 187,792 | 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.