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 |
|---|---|---|---|---|
| Kennett Square, PA | $367.22 | $367.22 – $367.22 | 10,831 | 1 |
| Napoleon, OH | $137.96 | $21.17 – $168.23 | 10,818 | 14 |
| Summerville, SC | $70.88 | $19.99 – $77.35 | 10,798 | 11 |
| Rancho Mirage, CA | $114.64 | $0.00 – $121.55 | 10,795 | 5 |
| Schofield, WI | $16.68 | $11.58 – $43.58 | 10,784 | 4 |
| Bountiful, UT | $2.62 | $2.62 – $2.62 | 10,776 | 1 |
| Ottumwa, IA | $6.14 | $0.00 – $56.05 | 10,767 | 3 |
| Springboro, OH | $145.86 | $41.80 – $153.18 | 10,671 | 6 |
| Kenova, WV | $115.55 | $115.28 – $121.41 | 10,660 | 2 |
| Kingsford, MI | $125.23 | $125.23 – $125.23 | 10,652 | 1 |
| Garden City, KS | $29.59 | $0.08 – $48.13 | 10,641 | 2 |
| Corinth, MS | $23.45 | $23.45 – $23.45 | 10,633 | 1 |
| Smyrna, DE | $0.00 | $0.00 – $0.00 | 10,628 | 1 |
| Yorkville, IL | $79.81 | $61.39 – $82.09 | 10,613 | 2 |
| Porter, OK | $71.53 | $71.53 – $71.53 | 10,610 | 1 |
| Anderson, CA | $35.29 | $24.00 – $35.43 | 10,599 | 2 |
| New Britain, CT | $95.71 | $0.00 – $157.84 | 10,581 | 18 |
| Stony Brook, NY | $56.38 | $6.96 – $101.77 | 10,578 | 3 |
| Conway, AR | $87.95 | $24.08 – $95.06 | 10,571 | 10 |
| Arkadelphia, AR | $71.32 | $71.02 – $75.79 | 10,561 | 2 |
| Kaneohe, HI | $65.57 | $15.50 – $94.34 | 10,556 | 2 |
| St Louis Park, MN | $103.05 | $71.54 – $440.29 | 10,552 | 6 |
| Palm Bay, FL | $71.60 | $10.75 – $84.15 | 10,541 | 6 |
| Mustang, OK | $68.62 | $50.26 – $74.03 | 10,537 | 7 |
| Barnsdall, OK | $89.77 | $0.00 – $517.53 | 10,528 | 12 |
| Worthington, OH | $78.56 | $0.00 – $147.68 | 10,525 | 17 |
| Cedar Point, NC | $114.92 | $114.92 – $114.92 | 10,517 | 1 |
| Rose Hill, NC | $131.93 | $131.93 – $131.93 | 10,499 | 1 |
| Broken Bow, OK | $67.64 | $64.31 – $69.65 | 10,484 | 6 |
| Derwood, MD | $434.77 | $67.68 – $435.64 | 10,484 | 2 |
| Newfield, NJ | $118.62 | $118.62 – $118.62 | 10,465 | 1 |
| Ottawa, KS | $46.28 | $0.00 – $57.31 | 10,457 | 2 |
| Phillipsburg, NJ | $70.58 | $23.07 – $114.95 | 10,394 | 7 |
| Omaha, NE | $90.81 | $0.00 – $262.98 | 10,392 | 20 |
| Aliso Viejo, CA | $97.46 | $0.00 – $97.65 | 10,391 | 2 |
| Whitesboro, OK | $68.61 | $25.32 – $68.71 | 10,386 | 2 |
| Kinsman, OH | $183.57 | $183.57 – $183.57 | 10,346 | 1 |
| Sandusky, MI | $166.25 | $89.26 – $180.76 | 10,340 | 2 |
| Shelbyville, IL | $99.33 | $42.96 – $102.00 | 10,340 | 2 |
| Middletown, RI | $59.47 | $0.00 – $92.08 | 10,326 | 6 |
| Boynton Beach, FL | $114.53 | $14.59 – $117.26 | 10,300 | 4 |
| Saranac Lake, NY | $246.61 | $246.61 – $246.61 | 10,266 | 1 |
| Warrenton, OR | $32.42 | $1.74 – $147.06 | 10,243 | 11 |
| Old Bridge, NJ | $73.50 | $73.50 – $73.50 | 10,220 | 1 |
| Malvern, AR | $96.70 | $0.00 – $108.49 | 10,210 | 7 |
| West Jordan, UT | $54.85 | $0.00 – $105.15 | 10,186 | 11 |
| Camden, ME | $89.66 | $67.51 – $95.50 | 10,177 | 4 |
| Eloy, AZ | $86.69 | $0.00 – $143.27 | 10,161 | 5 |
| Saltville, VA | $11.70 | $0.00 – $13.53 | 10,150 | 5 |
| Old Town, ME | $85.23 | $70.90 – $96.61 | 10,145 | 5 |
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.