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 |
|---|---|---|---|---|
| Littleton, CO | $88.64 | $0.00 – $1,383 | 133,109 | 56 |
| Columbia, MO | $44.32 | $0.00 – $73.39 | 132,995 | 8 |
| Tuscaloosa, AL | $77.24 | $24.71 – $87.04 | 132,647 | 6 |
| New London, NH | $11.14 | $8.40 – $13.88 | 132,541 | 2 |
| Farmington, NM | $115.57 | $0.00 – $171.57 | 132,350 | 23 |
| Lees Summit, MO | $0.00 | $0.00 – $0.00 | 132,207 | 4 |
| Weaverville, NC | $31.34 | $31.34 – $31.34 | 131,984 | 1 |
| Kearneysville, WV | $155.47 | $34.80 – $161.58 | 130,981 | 5 |
| Pontiac, MI | $43.30 | $1.65 – $235.16 | 130,217 | 9 |
| Fort Lauderdale, FL | $15.26 | $7.24 – $31.32 | 129,976 | 15 |
| Belen, NM | $61.53 | $4.85 – $183.67 | 129,023 | 3 |
| Alton, IL | $81.19 | $49.80 – $85.98 | 128,805 | 5 |
| Niagra Falls, NY | $23.77 | $23.77 – $23.77 | 128,682 | 1 |
| Port Richey, FL | $53.24 | $0.00 – $65.41 | 128,660 | 5 |
| Shelby, OH | $176.63 | $19.82 – $221.60 | 128,629 | 64 |
| Parma, OH | $124.06 | $0.00 – $278.17 | 128,011 | 33 |
| Lakewood, OH | $106.76 | $2.61 – $248.19 | 127,504 | 13 |
| Dunkirk, NY | $23.93 | $23.93 – $23.93 | 126,832 | 1 |
| Show Low, AZ | $36.59 | $1.44 – $586.81 | 126,302 | 10 |
| Troy, NY | $35.34 | $0.00 – $129.76 | 124,987 | 15 |
| Espanola, NM | $170.43 | $9.58 – $189.59 | 124,888 | 22 |
| Roswell, NM | $55.23 | $0.00 – $167.28 | 124,473 | 14 |
| San Rafael, CA | $140.74 | $33.43 – $166.14 | 123,484 | 8 |
| Grand Rapids, MN | $158.93 | $0.00 – $3,027 | 123,260 | 17 |
| Richmond, IN | $235.08 | $15.91 – $350.58 | 123,136 | 8 |
| Calexico, CA | $35.23 | $21.49 – $354.28 | 122,242 | 3 |
| Callaway, MD | $63.72 | $63.72 – $63.72 | 122,050 | 1 |
| Lake Havasu City, AZ | $37.58 | $0.00 – $198.28 | 121,729 | 7 |
| Haddam, CT | $153.68 | $153.68 – $153.68 | 121,553 | 1 |
| Oswego, NY | $34.45 | $34.25 – $44.27 | 121,293 | 3 |
| Cottonwood, AZ | $81.76 | $5.03 – $185.16 | 121,253 | 23 |
| Atoka, OK | $66.01 | $0.00 – $73.64 | 121,127 | 33 |
| Marion, LA | $287.72 | $287.72 – $287.72 | 120,594 | 1 |
| Grants Pass, OR | $48.99 | $0.00 – $386.99 | 120,085 | 113 |
| Ithaca, NY | $41.10 | $7.93 – $167.48 | 119,813 | 8 |
| Waldorf, MD | $67.67 | $29.65 – $214.22 | 119,640 | 13 |
| Point Pleasant, WV | $178.00 | $21.74 – $179.29 | 119,358 | 4 |
| Marana, AZ | $9.50 | $0.00 – $197.91 | 119,166 | 11 |
| Cortez, CO | $125.60 | $0.00 – $206.41 | 118,621 | 17 |
| Franklin, MA | $13.68 | $12.87 – $75.45 | 118,057 | 3 |
| Prineville, OR | $73.76 | $0.00 – $213.27 | 118,017 | 49 |
| Zebulon, NC | $37.38 | $37.38 – $37.38 | 117,475 | 1 |
| Sanford, NC | $30.54 | $26.54 – $171.91 | 117,431 | 2 |
| Gwynn Oak, MD | $154.62 | $55.83 – $246.46 | 117,113 | 6 |
| Moreno Valley, CA | $36.20 | $0.00 – $345.44 | 116,788 | 71 |
| Bartlesville, OK | $59.89 | $0.00 – $180.01 | 116,243 | 94 |
| Hawaiian Gardens, CA | $18.95 | $0.00 – $18.99 | 115,556 | 3 |
| Sparks, NV | $28.87 | $2.01 – $121.12 | 115,510 | 17 |
| Enfield, CT | $10.19 | $9.72 – $168.66 | 115,480 | 7 |
| Culpeper, VA | $8.05 | $7.97 – $23.29 | 114,571 | 3 |
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.