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 |
|---|---|---|---|---|
| Williamsburg, VA | $62.47 | $9.62 – $329.37 | 173,307 | 18 |
| Saint Joseph, MO | $5.50 | $0.00 – $87.84 | 172,736 | 4 |
| Brainerd, MN | $189.13 | $13.27 – $7,216 | 172,273 | 10 |
| Hickory, NC | $81.54 | $0.00 – $164.85 | 172,184 | 8 |
| Cape Girardeau, MO | $65.14 | $6.06 – $128.36 | 170,944 | 5 |
| Jersey City, NJ | $99.46 | $0.00 – $236.73 | 170,607 | 7 |
| Middletown, NY | $67.54 | $0.00 – $182.61 | 169,986 | 10 |
| Elk Grove Village, IL | $98.36 | $98.36 – $98.36 | 169,824 | 1 |
| Longmont, CO | $22.73 | $0.00 – $255.42 | 169,528 | 20 |
| Westhampton Beach, NY | $64.96 | $64.96 – $64.96 | 169,105 | 1 |
| Hayes, VA | $9.58 | $8.92 – $135.71 | 168,873 | 2 |
| Ashtabula, OH | $115.89 | $18.64 – $264.01 | 168,224 | 107 |
| Nashua, NH | $143.89 | $0.00 – $224.70 | 168,205 | 30 |
| Jacksonville, NC | $61.38 | $12.41 – $139.75 | 168,123 | 6 |
| Beaver, WV | $96.40 | $0.00 – $148.61 | 168,101 | 4 |
| Clayton, NC | $44.30 | $21.12 – $163.80 | 167,971 | 3 |
| Saint Charles, MO | $90.50 | $0.00 – $166.94 | 167,366 | 6 |
| Muskogee, OK | $68.32 | $0.00 – $640.00 | 167,111 | 107 |
| Clifton Springs, NY | $125.63 | $51.36 – $125.68 | 166,246 | 2 |
| Zanesville, OH | $140.43 | $4.14 – $288.98 | 165,494 | 92 |
| Albany, OR | $52.59 | $0.00 – $210.29 | 165,145 | 74 |
| Venice, CA | $20.48 | $19.12 – $84.19 | 164,769 | 2 |
| Arlington, VA | $508.30 | $0.68 – $633.29 | 164,119 | 10 |
| Princeton, WV | $113.71 | $0.00 – $139.11 | 163,491 | 14 |
| Springfield, OR | $44.71 | $0.00 – $3,555 | 163,437 | 64 |
| Aberdeen, MD | $71.44 | $66.66 – $104.27 | 162,550 | 6 |
| Amsterdam, NY | $32.41 | $32.08 – $39.65 | 161,813 | 4 |
| Puyallup, WA | $92.42 | $0.00 – $475.81 | 161,801 | 112 |
| Trenton, NJ | $72.43 | $0.00 – $94.03 | 161,574 | 16 |
| Lafayette, LA | $92.55 | $0.00 – $225.96 | 161,440 | 34 |
| Spokane Valley, WA | $25.34 | $0.00 – $575.00 | 161,394 | 69 |
| Nampa, ID | $159.54 | $0.00 – $375.88 | 159,904 | 34 |
| Lebanon, OH | $79.54 | $0.00 – $194.46 | 159,679 | 43 |
| Corona, CA | $36.60 | $0.00 – $292.67 | 158,709 | 26 |
| Broken Arrow, OK | $64.28 | $0.00 – $296.14 | 158,396 | 77 |
| Bullhead City, AZ | $39.66 | $4.70 – $252.07 | 157,614 | 10 |
| High Point, NC | $141.68 | $63.51 – $163.79 | 157,559 | 4 |
| Seaford, DE | $19.68 | $5.72 – $19.69 | 157,294 | 2 |
| Golden, CO | $39.37 | $0.00 – $621.68 | 157,123 | 7 |
| Oak Park, IL | $51.91 | $0.00 – $136.82 | 156,784 | 14 |
| Burnsville, MN | $84.90 | $14.06 – $376.38 | 156,443 | 10 |
| Pleasantville, NJ | $67.37 | $0.00 – $110.24 | 156,440 | 5 |
| West Covina, CA | $24.82 | $0.00 – $25.01 | 156,348 | 8 |
| Southgate, MI | $29.64 | $0.00 – $63.68 | 155,117 | 4 |
| Whitman, MA | $52.41 | $51.22 – $52.41 | 154,946 | 2 |
| Biddeford, ME | $98.78 | $0.00 – $210.78 | 154,685 | 81 |
| Staunton, VA | $104.54 | $11.44 – $304.99 | 154,147 | 2 |
| Norwalk, CA | $25.68 | $0.00 – $168.62 | 153,551 | 7 |
| Tishomingo, OK | $66.37 | $0.62 – $73.45 | 153,427 | 30 |
| La Mirada, CA | $24.21 | $24.21 – $24.21 | 151,927 | 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.