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 |
|---|---|---|---|---|
| Whitehall, OH | $113.45 | $0.00 – $333.49 | 89,749 | 71 |
| Berwyn, IL | $104.08 | $0.00 – $106.12 | 89,713 | 5 |
| Montgomery, AL | $55.85 | $0.00 – $110.18 | 89,700 | 10 |
| Winston Salem, NC | $80.43 | $13.59 – $261.90 | 89,466 | 16 |
| Covina, CA | $114.04 | $0.00 – $272.39 | 88,987 | 9 |
| Redmond, OR | $81.85 | $0.58 – $549.90 | 88,825 | 54 |
| Newburgh, NY | $156.09 | $11.02 – $175.57 | 88,433 | 7 |
| Newark, CA | $86.04 | $0.00 – $86.63 | 87,926 | 3 |
| Juneau, AK | $716.96 | $0.00 – $864.34 | 87,125 | 21 |
| West Chester, OH | $93.30 | $0.00 – $190.87 | 87,010 | 47 |
| Cambridge, MA | $63.43 | $57.43 – $63.44 | 86,792 | 3 |
| Lewiston, ID | $102.12 | $0.00 – $161.15 | 86,773 | 7 |
| Jackson, OH | $116.20 | $17.88 – $187.55 | 86,604 | 67 |
| Shelby, NC | $48.33 | $1.53 – $230.17 | 86,190 | 8 |
| Redford, MI | $63.48 | $38.96 – $69.01 | 85,921 | 2 |
| Moline, IL | $75.66 | $8.06 – $121.86 | 85,865 | 5 |
| Rockland, ME | $60.84 | $3.57 – $162.34 | 85,044 | 33 |
| Egg Harbor Township, NJ | $91.91 | $28.38 – $112.67 | 84,650 | 3 |
| Steubenville, OH | $104.49 | $13.88 – $224.82 | 84,458 | 47 |
| Wooster, OH | $140.80 | $0.00 – $215.57 | 83,793 | 60 |
| Wheaton, IL | $91.96 | $0.00 – $121.07 | 83,769 | 8 |
| Pemberton, NJ | $197.45 | $112.05 – $413.89 | 83,608 | 3 |
| Bradenton, FL | $51.04 | $0.00 – $81.27 | 83,246 | 9 |
| South Burlington, VT | $447.71 | $48.99 – $901.46 | 83,118 | 10 |
| Elizabeth, NJ | $83.93 | $0.03 – $121.50 | 83,106 | 7 |
| Tukwila, WA | $8.68 | $0.00 – $238.86 | 83,032 | 82 |
| Euclid, OH | $106.37 | $17.29 – $296.82 | 82,531 | 24 |
| Massillon, OH | $155.61 | $13.26 – $285.91 | 82,296 | 53 |
| Sun City, AZ | $235.77 | $0.00 – $2,182 | 82,244 | 7 |
| Downey, CA | $60.79 | $0.00 – $75.50 | 82,057 | 9 |
| Bismarck, ND | $156.30 | $0.00 – $595.77 | 81,422 | 100 |
| Weymouth, MA | $13.93 | $12.22 – $91.18 | 80,888 | 6 |
| Keyser, WV | $16.07 | $0.00 – $50.09 | 80,848 | 5 |
| Dover, OH | $45.88 | $32.21 – $308.95 | 80,781 | 23 |
| Union, NJ | $113.73 | $54.04 – $114.02 | 80,721 | 2 |
| Bethpage, NY | $65.80 | $65.80 – $65.80 | 80,642 | 1 |
| Newark, OH | $109.98 | $0.00 – $396.96 | 80,607 | 71 |
| Morehead City, NC | $51.83 | $49.71 – $133.72 | 80,197 | 3 |
| Atlanta, GA | $46.15 | $0.00 – $162.66 | 79,959 | 16 |
| Hanover, MD | $139.99 | $64.01 – $178.39 | 79,786 | 3 |
| Woods Cross, UT | $7.08 | $6.05 – $424.16 | 79,765 | 2 |
| Russell Springs, KY | $56.29 | $55.71 – $116.00 | 79,745 | 3 |
| Christiansburg, VA | $13.21 | $12.80 – $139.06 | 79,689 | 5 |
| Miami, OK | $130.24 | $0.00 – $719.00 | 79,140 | 58 |
| Dallas, OR | $56.09 | $1.45 – $123.95 | 79,066 | 36 |
| Catonsville, MD | $160.32 | $42.19 – $242.85 | 79,063 | 14 |
| Brewer, ME | $81.31 | $19.34 – $106.60 | 78,920 | 25 |
| North Stonington, CT | $119.48 | $116.40 – $134.81 | 78,906 | 3 |
| Neptune, NJ | $86.27 | $85.91 – $112.53 | 78,694 | 3 |
| Beaverton, OR | $73.63 | $0.00 – $346.77 | 78,576 | 90 |
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.