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 |
|---|---|---|---|---|
| Tacoma, WA | $23.01 | $0.00 – $445.34 | 1,688,118 | 309 |
| Mount Pleasant, MI | $12.40 | $12.40 – $12.40 | 1,684,532 | 1 |
| Buffalo, NY | $44.27 | $0.00 – $3,206 | 1,684,325 | 45 |
| Virginia Beach, VA | $33.68 | $0.00 – $3,204 | 1,632,068 | 39 |
| Pascagoula, MS | $2.61 | $2.61 – $2.61 | 1,572,431 | 1 |
| Millsboro, DE | $9.82 | $0.00 – $9.82 | 1,522,908 | 2 |
| Madison, WI | $12.67 | $0.00 – $125.02 | 1,509,772 | 199 |
| Woodbury, MN | $15.11 | $0.00 – $281.03 | 1,506,966 | 6 |
| Lakewood, WA | $25.81 | $0.00 – $233.37 | 1,497,008 | 191 |
| Everett, WA | $21.85 | $0.00 – $295.30 | 1,489,423 | 326 |
| West Haven, CT | $14.10 | $0.00 – $166.07 | 1,473,823 | 8 |
| Portsmouth, OH | $118.94 | $0.00 – $293.24 | 1,451,815 | 548 |
| New Bedford, MA | $40.55 | $0.91 – $66.53 | 1,445,774 | 15 |
| Stratford, CT | $13.65 | $0.00 – $166.28 | 1,419,950 | 5 |
| Lakewood, CO | $117.49 | $0.00 – $722.35 | 1,393,242 | 70 |
| San Diego, CA | $88.82 | $0.00 – $492.32 | 1,360,427 | 123 |
| Marion, IN | $16.68 | $14.78 – $60.64 | 1,299,424 | 5 |
| North Chesterfield, VA | $11.58 | $9.23 – $214.34 | 1,291,358 | 13 |
| Milwaukee, WI | $16.12 | $0.00 – $412.01 | 1,287,629 | 260 |
| Olympia, WA | $31.14 | $0.00 – $342.80 | 1,271,357 | 225 |
| Vancouver, WA | $29.50 | $0.00 – $615.37 | 1,271,002 | 335 |
| Fall River, MA | $23.69 | $11.23 – $192.53 | 1,252,274 | 23 |
| Roanoke, VA | $44.31 | $0.00 – $4,868 | 1,236,004 | 43 |
| Centennial, CO | $32.38 | $0.00 – $1,158 | 1,220,225 | 24 |
| Las Vegas, NV | $43.50 | $0.00 – $914.74 | 1,203,061 | 700 |
| Spokane, WA | $48.18 | $0.00 – $987.35 | 1,200,554 | 559 |
| Louisa, KY | $53.39 | $9.61 – $192.75 | 1,192,329 | 39 |
| Manchester, NH | $19.87 | $0.00 – $267.75 | 1,179,036 | 52 |
| Riverside, CA | $45.82 | $0.00 – $600.71 | 1,177,631 | 129 |
| Concord, NH | $36.35 | $8.59 – $269.79 | 1,176,953 | 25 |
| Youngstown, OH | $58.61 | $0.00 – $400.00 | 1,171,423 | 227 |
| Saginaw, MI | $22.44 | $1.83 – $1,002 | 1,163,447 | 24 |
| Kalamazoo, MI | $22.55 | $1.37 – $1,189 | 1,148,823 | 15 |
| Carmichael, CA | $21.34 | $0.00 – $21.37 | 1,131,689 | 11 |
| Grand Junction, CO | $154.69 | $0.00 – $1,163 | 1,131,371 | 50 |
| Toledo, OH | $102.58 | $0.00 – $380.34 | 1,129,559 | 567 |
| Lansing, MI | $21.23 | $3.97 – $174.82 | 1,118,542 | 9 |
| Wilmington, DE | $14.51 | $0.00 – $146.44 | 1,110,493 | 19 |
| Chesapeake, VA | $18.15 | $0.00 – $581.71 | 1,094,970 | 20 |
| Yuma, AZ | $58.77 | $0.00 – $272.93 | 1,090,869 | 36 |
| Saint Paul, MN | $156.45 | $0.00 – $1,545 | 1,054,606 | 74 |
| Gretna, LA | $13.72 | $12.44 – $117.61 | 1,054,410 | 4 |
| Pulaski, VA | $10.34 | $10.34 – $10.34 | 1,042,946 | 1 |
| Hammond, LA | $9.15 | $8.69 – $176.98 | 1,033,639 | 6 |
| Arlington, WA | $16.64 | $14.79 – $183.25 | 1,023,525 | 10 |
| Syracuse, NY | $62.37 | $0.55 – $178.93 | 1,023,428 | 20 |
| Anchorage, AK | $64.37 | $0.00 – $991.61 | 1,005,408 | 144 |
| Fort Wayne, IN | $88.84 | $0.00 – $457.93 | 999,164 | 20 |
| Clinton, MO | $9.95 | $0.00 – $100.35 | 973,497 | 10 |
| Highland Park, MI | $10.04 | $9.62 – $160.29 | 969,658 | 2 |
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.