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 |
|---|---|---|---|---|
| Desert Hot Springs, CA | $91.77 | $0.00 – $262.00 | 45,213 | 5 |
| Edina, MN | $83.56 | $10.26 – $94.33 | 45,209 | 5 |
| Fort Smith, AR | $65.86 | $0.00 – $88.72 | 45,176 | 13 |
| Georgetown, OH | $94.45 | $0.00 – $244.11 | 45,156 | 37 |
| Globe, AZ | $55.99 | $44.02 – $184.93 | 45,081 | 4 |
| Purcell, OK | $66.28 | $57.56 – $73.46 | 45,065 | 16 |
| Goodyear, AZ | $158.11 | $0.00 – $1,877 | 45,059 | 14 |
| St Cloud, MN | $178.38 | $160.52 – $674.74 | 44,995 | 4 |
| Mora, MN | $505.39 | $24.42 – $1,392 | 44,730 | 6 |
| Douglas, AZ | $102.55 | $0.00 – $122.47 | 44,692 | 7 |
| Springvale, ME | $84.72 | $29.41 – $136.01 | 44,609 | 26 |
| Hoquiam, WA | $78.31 | $0.00 – $172.90 | 44,582 | 19 |
| Oldsmar, FL | $50.93 | $50.93 – $50.93 | 44,531 | 1 |
| Pekin, IL | $79.88 | $26.43 – $84.56 | 44,505 | 5 |
| Mishawaka, IN | $382.09 | $126.49 – $383.42 | 44,432 | 2 |
| Bedford, IN | $418.90 | $418.90 – $418.90 | 44,412 | 1 |
| White River Junction, VT | $16.03 | $10.25 – $90.47 | 44,399 | 2 |
| Crownsville, MD | $144.18 | $109.07 – $177.97 | 44,374 | 4 |
| Concord, MA | $46.90 | $0.00 – $67.62 | 44,340 | 3 |
| Slidell, LA | $111.22 | $25.30 – $124.35 | 44,332 | 16 |
| Kingston, OK | $69.84 | $41.16 – $73.13 | 44,216 | 11 |
| Ottawa, IL | $73.49 | $53.16 – $74.67 | 44,119 | 3 |
| West Frankfort, IL | $82.16 | $0.00 – $83.72 | 43,930 | 4 |
| New Philadelphia, OH | $109.22 | $25.74 – $195.14 | 43,772 | 31 |
| Palos Hills, IL | $94.16 | $94.16 – $94.16 | 43,740 | 1 |
| South Boston, MA | $244.37 | $104.13 – $265.65 | 43,728 | 3 |
| Brentwood, TN | $129.87 | $24.00 – $284.95 | 43,678 | 18 |
| Lafayette, CO | $38.62 | $0.00 – $300.40 | 43,655 | 27 |
| Glenwood, MD | $84.78 | $75.40 – $92.31 | 43,651 | 3 |
| Gardena, CA | $95.39 | $0.00 – $157.10 | 43,622 | 7 |
| Supply, NC | $103.74 | $103.74 – $103.74 | 43,501 | 1 |
| Lisbon, OH | $89.47 | $21.15 – $235.55 | 43,433 | 27 |
| Trumansburg, NY | $205.38 | $205.38 – $205.38 | 43,406 | 1 |
| Campbellsville, KY | $170.23 | $0.00 – $261.83 | 43,309 | 12 |
| Atlantic City, NJ | $77.24 | $0.00 – $109.48 | 43,281 | 4 |
| Galloway, NJ | $102.92 | $9.83 – $110.72 | 43,251 | 4 |
| Belfast, ME | $100.70 | $55.92 – $179.89 | 43,103 | 25 |
| Getzville, NY | $120.54 | $120.54 – $120.54 | 43,085 | 1 |
| Brunswick, GA | $59.25 | $57.41 – $61.96 | 42,919 | 2 |
| Perris, CA | $82.50 | $0.00 – $419.38 | 42,853 | 21 |
| Paso Robles, CA | $90.39 | $0.00 – $90.56 | 42,708 | 2 |
| Riverhead, NY | $29.80 | $26.08 – $90.44 | 42,653 | 6 |
| Pryor, OK | $51.91 | $0.00 – $314.01 | 42,598 | 65 |
| Tulalip, WA | $33.36 | $24.82 – $111.78 | 42,381 | 3 |
| Madill, OK | $60.06 | $53.98 – $72.86 | 42,018 | 7 |
| Marion, IL | $80.58 | $53.00 – $128.25 | 41,950 | 8 |
| Ewing, NJ | $91.65 | $33.71 – $109.74 | 41,908 | 6 |
| Harvey, LA | $87.11 | $10.10 – $123.71 | 41,792 | 4 |
| Sterling, CO | $154.01 | $27.18 – $280.05 | 41,757 | 7 |
| Lutz, FL | $31.68 | $31.68 – $31.68 | 41,720 | 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.