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 |
|---|---|---|---|---|
| Irvine, CA | $62.56 | $0.00 – $247.55 | 13,233 | 15 |
| Smithtown, NY | $38.89 | $31.03 – $57.70 | 13,223 | 3 |
| Westport, CT | $397.65 | $397.65 – $397.65 | 13,191 | 1 |
| Spring Valley, NY | $134.06 | $134.06 – $134.06 | 13,150 | 1 |
| Nyc, NY | $25.52 | $25.52 – $25.52 | 13,150 | 1 |
| Baldwin, MI | $3.64 | $3.55 – $5.70 | 13,144 | 2 |
| Edmonds, WA | $17.25 | $0.00 – $164.47 | 13,117 | 16 |
| Kenton, OH | $95.30 | $17.50 – $321.89 | 13,100 | 12 |
| Monticello, MN | $82.63 | $82.63 – $82.63 | 13,093 | 1 |
| Fort Sam Houston, TX | $73.32 | $43.43 – $83.65 | 13,065 | 3 |
| West Memphis, AR | $96.04 | $53.94 – $109.20 | 13,036 | 7 |
| Westlake, OH | $185.95 | $28.90 – $208.10 | 13,027 | 6 |
| Rhinelander, WI | $28.55 | $7.64 – $55.70 | 13,027 | 9 |
| Menomonie, WI | $40.53 | $6.98 – $65.42 | 13,018 | 12 |
| Kennebunk, ME | $73.35 | $39.75 – $109.84 | 12,986 | 15 |
| Freeport, NY | $32.85 | $0.48 – $146.46 | 12,981 | 3 |
| Yreka, CA | $74.04 | $74.04 – $74.04 | 12,978 | 1 |
| Alabaster, AL | $426.86 | $426.86 – $426.86 | 12,970 | 1 |
| Van Buren, ME | $165.72 | $165.72 – $165.72 | 12,968 | 1 |
| Swansea, IL | $61.58 | $61.58 – $61.58 | 12,947 | 1 |
| Clearlake, CA | $78.31 | $40.00 – $78.37 | 12,939 | 2 |
| Landover, MD | $77.08 | $0.00 – $97.05 | 12,923 | 9 |
| Hazel Crest, IL | $68.06 | $48.98 – $68.14 | 12,908 | 3 |
| Fife, WA | $15.02 | $0.00 – $154.49 | 12,907 | 9 |
| Burns, OR | $17.36 | $0.00 – $37.50 | 12,891 | 16 |
| Coos Bay, OR | $48.90 | $0.00 – $104.99 | 12,837 | 22 |
| La Porte, IN | $377.27 | $43.63 – $442.54 | 12,823 | 3 |
| Charleston, IL | $55.20 | $46.28 – $95.64 | 12,817 | 8 |
| Pacoima, CA | $83.82 | $83.82 – $83.82 | 12,804 | 1 |
| The Dalles, OR | $35.37 | $0.00 – $157.35 | 12,797 | 29 |
| Tyler, TX | $12.52 | $11.36 – $57.01 | 12,788 | 4 |
| Oxford, MI | $353.44 | $18.08 – $382.46 | 12,782 | 2 |
| West Gardiner, ME | $85.35 | $72.69 – $88.17 | 12,765 | 2 |
| Stringtown, OK | $60.73 | $58.15 – $67.70 | 12,691 | 2 |
| Nellis Afb, NV | $109.84 | $2.17 – $318.94 | 12,672 | 8 |
| Gooding, ID | $170.92 | $56.55 – $477.65 | 12,617 | 3 |
| Middleton, WI | $20.18 | $11.21 – $38.63 | 12,615 | 4 |
| Blackfoot, ID | $95.31 | $58.21 – $124.31 | 12,614 | 5 |
| Plano, TX | $41.55 | $8.27 – $113.42 | 12,608 | 5 |
| Eden Prairie, MN | $119.53 | $116.06 – $120.01 | 12,598 | 2 |
| Du Quoin, IL | $83.53 | $83.53 – $83.53 | 12,577 | 1 |
| Hinesville, GA | $65.03 | $0.83 – $73.27 | 12,574 | 3 |
| Madawaska, ME | $74.24 | $49.28 – $92.66 | 12,570 | 9 |
| Demopolis, AL | $54.74 | $54.74 – $54.74 | 12,556 | 1 |
| Crestwood, KY | $266.70 | $15.39 – $291.60 | 12,542 | 4 |
| Cheyenne, WY | $60.99 | $18.89 – $202.69 | 12,505 | 23 |
| Center City, MN | $99.91 | $17.13 – $108.56 | 12,493 | 2 |
| Parker, AZ | $79.51 | $10.62 – $144.29 | 12,439 | 6 |
| Galt, CA | $246.17 | $0.00 – $258.46 | 12,427 | 2 |
| Asher, OK | $146.37 | $146.37 – $146.37 | 12,420 | 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.