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 β $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 β 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 |
|---|---|---|---|---|
| Johnson City, TN | $85.80 | $0.00 β $303.62 | 151,247 | 49 |
| Rockingham, NC | $139.19 | $139.19 β $139.19 | 150,509 | 1 |
| Buckeye, AZ | $76.69 | $15.57 β $125.22 | 150,445 | 8 |
| Middletown, OH | $66.15 | $1.42 β $322.98 | 149,917 | 64 |
| Bel Camp, MD | $69.86 | $69.86 β $69.86 | 149,692 | 1 |
| Elkins, WV | $51.55 | $0.00 β $99.14 | 148,622 | 5 |
| Carson City, NV | $21.78 | $0.00 β $96.99 | 148,234 | 20 |
| Lawndale, CA | $18.37 | $18.37 β $18.37 | 148,031 | 1 |
| Shoreline, WA | $14.25 | $0.00 β $309.09 | 147,339 | 46 |
| Winslow, AZ | $88.39 | $41.46 β $111.08 | 146,899 | 4 |
| Garrison, NY | $144.15 | $144.15 β $144.15 | 146,769 | 1 |
| Springfield, IL | $87.09 | $38.99 β $126.17 | 145,004 | 9 |
| Lynwood, CA | $64.28 | $0.00 β $428.84 | 144,740 | 13 |
| Greenville, NC | $93.80 | $0.00 β $221.28 | 144,697 | 21 |
| Huntsville, AL | $104.50 | $0.00 β $243.39 | 144,039 | 16 |
| Paterson, NJ | $215.11 | $0.00 β $1,326 | 143,762 | 17 |
| Joliet, IL | $94.14 | $22.09 β $133.74 | 143,278 | 19 |
| Claremore, OK | $64.09 | $0.00 β $631.87 | 142,885 | 136 |
| Westland, MI | $73.83 | $72.00 β $87.81 | 142,767 | 4 |
| Azusa, CA | $20.41 | $0.60 β $20.44 | 142,501 | 2 |
| Marion, NC | $47.18 | $45.91 β $122.38 | 142,388 | 2 |
| Hugo, OK | $68.56 | $25.16 β $75.86 | 142,203 | 34 |
| Hendersonville, NC | $37.44 | $33.74 β $52.11 | 142,199 | 4 |
| Kingston, NY | $28.52 | $13.22 β $206.28 | 141,973 | 10 |
| Pocatello, ID | $91.17 | $0.00 β $254.22 | 141,837 | 36 |
| New Hyde Park, NY | $77.01 | $0.00 β $141.60 | 141,702 | 5 |
| Fairmont, WV | $85.18 | $0.00 β $292.44 | 141,089 | 6 |
| Coal Grove, OH | $130.97 | $16.24 β $198.43 | 140,271 | 46 |
| East Boston, MA | $54.95 | $54.95 β $54.95 | 140,212 | 1 |
| Mays Landing, NJ | $153.05 | $0.00 β $1,003 | 139,898 | 4 |
| Reynoldsburg, OH | $92.61 | $0.00 β $360.36 | 139,305 | 64 |
| Ellsworth, ME | $112.12 | $43.73 β $138.12 | 139,145 | 25 |
| Ammon, ID | $105.63 | $0.00 β $117.57 | 138,992 | 9 |
| Taylorsville, UT | $39.54 | $22.25 β $603.08 | 138,966 | 5 |
| Lavale, MD | $70.00 | $70.00 β $70.00 | 138,571 | 1 |
| San Antonio, TX | $16.20 | $0.00 β $177.76 | 138,224 | 18 |
| Danbury, CT | $154.65 | $0.00 β $169.48 | 138,050 | 18 |
| Tahlequah, OK | $112.60 | $0.00 β $719.00 | 137,479 | 87 |
| Oceanside, CA | $79.55 | $0.00 β $146.29 | 137,403 | 16 |
| Billings, MT | $135.45 | $0.00 β $236.96 | 137,202 | 9 |
| Stillwater, MN | $196.00 | $63.80 β $879.01 | 136,452 | 18 |
| Price, UT | $13.61 | $7.20 β $49.69 | 135,692 | 3 |
| Saint Clair Shores, MI | $11.37 | $11.37 β $11.37 | 135,276 | 1 |
| Cliffwood, NJ | $76.41 | $76.41 β $76.41 | 134,936 | 1 |
| Rockville, MD | $73.72 | $0.70 β $109.78 | 134,825 | 9 |
| Mentor, OH | $124.56 | $2.34 β $194.01 | 134,639 | 102 |
| Rocky Mount, NC | $35.29 | $2.89 β $204.17 | 134,569 | 9 |
| Lacassine, LA | $88.47 | $88.47 β $88.47 | 134,305 | 1 |
| Nottingham, MD | $178.48 | $67.23 β $205.00 | 133,551 | 5 |
| Siler City, NC | $34.83 | $34.83 β $34.83 | 133,182 | 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.