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 |
|---|---|---|---|---|
| Springfield, NJ | $55.53 | $0.00 – $109.81 | 6,184 | 3 |
| Amherst, NH | $53.26 | $53.26 – $53.26 | 6,174 | 1 |
| Tinton Falls, NJ | $68.53 | $40.56 – $124.91 | 6,141 | 2 |
| Claremont, NH | $74.85 | $9.08 – $1,065 | 6,141 | 4 |
| Bucyrus, OH | $137.99 | $36.77 – $166.61 | 6,131 | 5 |
| Marion, SC | $66.81 | $24.33 – $68.24 | 6,125 | 2 |
| Farmington Hills, MI | $57.54 | $0.00 – $80.24 | 6,112 | 5 |
| Evanston, WY | $64.41 | $0.00 – $152.06 | 6,100 | 7 |
| Malta, OH | $89.82 | $30.94 – $110.24 | 6,093 | 6 |
| Asheboro, NC | $102.82 | $0.50 – $255.52 | 6,072 | 8 |
| Allegany, NY | $92.11 | $92.11 – $92.11 | 6,071 | 1 |
| Brooklyn, OH | $132.76 | $25.80 – $133.46 | 6,043 | 2 |
| Columbia Falls, MT | $64.52 | $64.52 – $64.52 | 6,042 | 1 |
| Rock Valley, IA | $72.02 | $72.02 – $72.02 | 6,035 | 1 |
| Central Falls, RI | $18.63 | $18.63 – $18.63 | 6,035 | 1 |
| Sunrise, FL | $50.19 | $0.00 – $52.21 | 6,034 | 5 |
| North Waterboro, ME | $74.89 | $74.89 – $74.89 | 6,008 | 1 |
| Harrington, ME | $78.82 | $59.16 – $91.58 | 6,003 | 3 |
| Camp Verde, AZ | $62.35 | $62.35 – $62.35 | 6,002 | 1 |
| Stone Mountain, GA | $88.95 | $88.95 – $88.95 | 5,998 | 1 |
| Talbott, TN | $13.10 | $11.45 – $56.97 | 5,995 | 2 |
| Hayward, WI | $17.61 | $6.82 – $47.42 | 5,985 | 7 |
| North Mankato, MN | $93.53 | $44.18 – $147.51 | 5,981 | 4 |
| Sparta, NJ | $31.01 | $31.01 – $31.01 | 5,962 | 1 |
| Nyack, NY | $63.16 | $62.87 – $204.89 | 5,938 | 2 |
| Cumberland, ME | $96.42 | $56.92 – $97.35 | 5,926 | 2 |
| Oologah, OK | $53.70 | $0.00 – $69.51 | 5,923 | 6 |
| Sun Prairie, WI | $15.34 | $10.89 – $42.66 | 5,919 | 4 |
| North Lima, OH | $110.90 | $33.01 – $200.35 | 5,915 | 4 |
| Sugar City, ID | $87.80 | $87.65 – $103.44 | 5,908 | 2 |
| Walla Walla, WA | $9.04 | $0.00 – $67.14 | 5,898 | 18 |
| West Bend, WI | $51.20 | $8.98 – $157.92 | 5,885 | 8 |
| Chouteau, OK | $60.45 | $0.00 – $72.23 | 5,827 | 5 |
| Austin, TX | $22.32 | $0.00 – $131.48 | 5,826 | 9 |
| Princeton, KY | $105.18 | $24.41 – $107.60 | 5,825 | 2 |
| North Miami Beach, FL | $32.74 | $11.73 – $67.94 | 5,818 | 6 |
| Mason City, IA | $9.60 | $9.60 – $9.60 | 5,813 | 1 |
| Fishers, IN | $180.03 | $0.00 – $219.85 | 5,810 | 4 |
| Belleville, NJ | $0.00 | $0.00 – $0.00 | 5,798 | 1 |
| Colmar, PA | $94.24 | $94.24 – $94.24 | 5,795 | 1 |
| Opelousas, LA | $14.64 | $0.00 – $25.42 | 5,789 | 6 |
| Minden, LA | $65.49 | $8.43 – $79.93 | 5,776 | 5 |
| Lacey, WA | $81.50 | $0.00 – $296.39 | 5,772 | 15 |
| Sayville, NY | $125.51 | $125.51 – $125.51 | 5,760 | 1 |
| Latham, NY | $59.71 | $58.52 – $98.51 | 5,758 | 2 |
| Eden, NY | $753.74 | $753.74 – $753.74 | 5,758 | 1 |
| Central Point, OR | $54.32 | $0.00 – $94.33 | 5,739 | 14 |
| Springfield, GA | $71.56 | $71.56 – $71.56 | 5,732 | 1 |
| Crowley, LA | $69.85 | $1.83 – $112.03 | 5,713 | 5 |
| Kennebunkport, ME | $118.70 | $118.70 – $118.70 | 5,712 | 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.