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 |
|---|---|---|---|---|
| Ontario, OR | $15.89 | $0.00 – $151.11 | 28,612 | 36 |
| Somerton, AZ | $13.94 | $12.07 – $72.24 | 28,598 | 4 |
| Wewoka, OK | $52.94 | $40.92 – $65.23 | 28,586 | 6 |
| Nancy, KY | $47.61 | $0.00 – $69.63 | 28,558 | 5 |
| Pontiac, IL | $91.63 | $53.79 – $93.97 | 28,490 | 2 |
| Lake Worth, FL | $24.61 | $0.00 – $56.17 | 28,486 | 8 |
| New Lexington, OH | $122.70 | $18.91 – $233.78 | 28,422 | 30 |
| Prague, OK | $45.91 | $0.00 – $69.44 | 28,422 | 7 |
| Helena, MT | $84.39 | $0.00 – $336.21 | 28,409 | 10 |
| Mattoon, IL | $87.33 | $44.56 – $128.72 | 28,376 | 5 |
| Wauseon, OH | $175.56 | $34.25 – $206.59 | 28,307 | 8 |
| Wheeling, IL | $91.79 | $41.88 – $92.49 | 28,282 | 2 |
| Westerville, OH | $122.71 | $13.88 – $380.80 | 27,925 | 24 |
| Windsor, CO | $842.51 | $162.40 – $906.83 | 27,899 | 4 |
| Normal, IL | $93.11 | $78.87 – $93.80 | 27,719 | 4 |
| Oakdale, MN | $256.47 | $7.49 – $1,957 | 27,702 | 11 |
| Woodland, CA | $73.40 | $3.00 – $83.49 | 27,698 | 4 |
| Lawrenceville, IL | $73.65 | $54.05 – $73.87 | 27,669 | 2 |
| Castle Rock, WA | $15.63 | $11.64 – $120.62 | 27,608 | 8 |
| Edison, NJ | $101.05 | $0.00 – $111.25 | 27,504 | 7 |
| Marlboro, NJ | $1,092 | $936.18 – $1,352 | 27,474 | 2 |
| Hastings, MN | $89.78 | $64.01 – $155.03 | 27,434 | 5 |
| Florence, AL | $86.92 | $20.84 – $118.39 | 27,336 | 8 |
| Silver Springs, NV | $0.03 | $0.00 – $64.88 | 27,325 | 2 |
| Dover, NH | $51.15 | $17.93 – $96.67 | 27,303 | 12 |
| Plainville, CT | $16.79 | $0.00 – $150.12 | 27,302 | 9 |
| Coram, NY | $109.13 | $1.21 – $110.25 | 27,292 | 2 |
| Altus, OK | $64.82 | $1.45 – $188.76 | 27,290 | 19 |
| Missoula, MT | $96.72 | $0.00 – $233.85 | 27,269 | 12 |
| Henryville, PA | $249.80 | $249.80 – $249.80 | 27,222 | 1 |
| Mebane, NC | $133.40 | $133.25 – $144.06 | 27,196 | 2 |
| Fort Dodge, IA | $51.30 | $1.16 – $298.35 | 27,115 | 3 |
| Murray, UT | $40.45 | $24.41 – $97.43 | 27,020 | 5 |
| Gray, ME | $98.85 | $53.94 – $153.72 | 26,944 | 12 |
| Chestertown, MD | $47.83 | $47.76 – $48.11 | 26,923 | 2 |
| Piqua, OH | $78.46 | $0.00 – $275.83 | 26,882 | 21 |
| Lebanon, TN | $61.29 | $9.12 – $139.67 | 26,840 | 7 |
| Texarkana, TX | $70.85 | $47.04 – $90.76 | 26,802 | 5 |
| Mt Sterling, IL | $63.24 | $63.24 – $63.24 | 26,759 | 1 |
| Cass Lake, MN | $797.04 | $353.37 – $4,423 | 26,709 | 4 |
| Kokomo, IN | $187.34 | $26.83 – $459.08 | 26,703 | 10 |
| Elko, NV | $129.49 | $0.00 – $234.29 | 26,650 | 5 |
| Ionia, MI | $235.38 | $110.00 – $235.51 | 26,520 | 2 |
| Coweta, OK | $64.84 | $0.00 – $71.17 | 26,476 | 9 |
| Floyd, VA | $123.12 | $15.63 – $125.97 | 26,463 | 3 |
| Parksley, VA | $266.58 | $24.00 – $267.43 | 26,453 | 3 |
| Burlington, WI | $12.61 | $4.28 – $41.29 | 26,449 | 3 |
| Gladstone, OR | $67.78 | $49.45 – $213.36 | 26,370 | 15 |
| Chandler, OK | $66.68 | $0.00 – $71.56 | 26,366 | 12 |
| Phila, PA | $344.25 | $0.00 – $360.82 | 26,323 | 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.