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 |
|---|---|---|---|---|
| Wisconsin Rapids, WI | $43.97 | $0.00 – $55.11 | 5,705 | 9 |
| Garrett, KY | $18.14 | $18.14 – $18.14 | 5,691 | 1 |
| Madison, TN | $74.79 | $21.71 – $95.63 | 5,668 | 3 |
| Tonawanda, NY | $188.70 | $188.70 – $188.70 | 5,657 | 1 |
| Calumet, MI | $95.17 | $39.37 – $106.62 | 5,648 | 2 |
| Leipsic, OH | $167.61 | $167.61 – $167.61 | 5,638 | 1 |
| Fairfield, ME | $76.66 | $62.40 – $82.93 | 5,625 | 4 |
| Plymouth Meeting, PA | $294.60 | $294.60 – $294.60 | 5,613 | 1 |
| Fort Thomas, KY | $16.34 | $16.34 – $16.34 | 5,608 | 1 |
| Temple Hills, MD | $76.40 | $71.99 – $76.48 | 5,607 | 2 |
| Dillon, SC | $64.89 | $5.17 – $69.38 | 5,592 | 3 |
| Des Moines, WA | $10.23 | $0.00 – $23.66 | 5,568 | 12 |
| Sterling, IL | $85.71 | $67.23 – $108.70 | 5,558 | 3 |
| Colonial Heights, VA | $285.63 | $224.68 – $294.25 | 5,558 | 2 |
| Lake Crystal, MN | $1,888 | $1,888 – $1,888 | 5,534 | 1 |
| Holden, ME | $77.72 | $0.00 – $78.08 | 5,532 | 2 |
| Brandon, FL | $18.45 | $0.00 – $71.43 | 5,518 | 9 |
| Yarmouth, ME | $79.14 | $48.11 – $96.35 | 5,516 | 7 |
| Greenville, TX | $69.81 | $69.81 – $69.81 | 5,499 | 1 |
| South Paris, ME | $98.85 | $54.77 – $108.65 | 5,499 | 5 |
| King Of Prussia, PA | $98.70 | $62.58 – $110.10 | 5,476 | 2 |
| Talihina, OK | $71.62 | $71.62 – $71.62 | 5,476 | 1 |
| Randolph, ME | $73.63 | $37.67 – $79.52 | 5,469 | 5 |
| Abington, MA | $126.50 | $126.50 – $126.50 | 5,467 | 1 |
| Tualatin, OR | $45.82 | $0.00 – $132.43 | 5,464 | 7 |
| Sleepy Hollow, NY | $99.17 | $99.17 – $99.17 | 5,449 | 1 |
| Bowie, MD | $46.22 | $0.00 – $156.43 | 5,444 | 14 |
| Choctaw, OK | $56.53 | $37.20 – $70.54 | 5,433 | 10 |
| Raymond, ME | $77.85 | $66.18 – $81.09 | 5,425 | 4 |
| Fort Monmouth, NJ | $112.47 | $112.47 – $112.47 | 5,425 | 1 |
| Pine Knot, KY | $67.57 | $67.57 – $67.57 | 5,410 | 1 |
| Blytheville, AR | $95.41 | $58.74 – $101.83 | 5,404 | 3 |
| Florence, CO | $295.82 | $295.82 – $295.82 | 5,402 | 1 |
| Wildwood, NJ | $111.30 | $111.30 – $111.30 | 5,391 | 1 |
| Bellaire, OH | $127.66 | $57.33 – $182.38 | 5,388 | 8 |
| Parsons, KS | $33.79 | $0.00 – $54.54 | 5,379 | 2 |
| Mountlake Terrace, WA | $63.86 | $0.00 – $159.70 | 5,373 | 13 |
| Fort Worth, TX | $23.62 | $6.27 – $91.01 | 5,372 | 15 |
| Trabuco Canyon, CA | $80.86 | $80.86 – $80.86 | 5,366 | 1 |
| Tillamook, OR | $19.53 | $0.00 – $127.53 | 5,356 | 12 |
| Sells, AZ | $101.30 | $101.30 – $101.30 | 5,335 | 1 |
| Gurnee, IL | $58.59 | $21.64 – $72.95 | 5,327 | 5 |
| Paris, TX | $65.83 | $57.28 – $71.00 | 5,313 | 5 |
| Mount Prospect, IL | $139.89 | $139.89 – $139.89 | 5,313 | 1 |
| Port Clinton, OH | $69.56 | $40.55 – $145.02 | 5,294 | 10 |
| Ooltewah, TN | $80.64 | $80.64 – $80.64 | 5,286 | 1 |
| Westons Mills, NY | $145.89 | $145.89 – $145.89 | 5,277 | 1 |
| Hampton Bays, NY | $58.62 | $58.62 – $58.62 | 5,269 | 1 |
| Rice Lake, WI | $33.22 | $27.03 – $34.77 | 5,265 | 2 |
| Bridgewater, NJ | $247.65 | $109.41 – $275.33 | 5,251 | 4 |
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.