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 |
|---|---|---|---|---|
| Boston, MA | $47.20 | $0.00 – $420.77 | 509,112 | 53 |
| Hamilton, OH | $88.41 | $7.47 – $321.85 | 508,579 | 326 |
| Hemet, CA | $29.17 | $0.00 – $293.02 | 507,854 | 28 |
| Somerset, KY | $133.37 | $0.00 – $276.93 | 507,692 | 62 |
| Ashland, KY | $95.73 | $0.00 – $506.70 | 505,064 | 53 |
| Providence, RI | $47.48 | $0.00 – $226.19 | 496,940 | 48 |
| Bettendorf, IA | $14.51 | $13.93 – $75.77 | 496,752 | 3 |
| Wheeler, OR | $9.52 | $9.52 – $9.52 | 492,289 | 1 |
| Waukesha, WI | $11.31 | $3.78 – $46.80 | 490,331 | 55 |
| Harrisonburg, VA | $34.57 | $7.68 – $326.54 | 488,784 | 8 |
| Lumberton, NC | $90.17 | $20.86 – $268.12 | 486,602 | 16 |
| Chillicothe, OH | $107.40 | $0.00 – $382.78 | 484,851 | 212 |
| Wilmington, CA | $22.73 | $0.00 – $104.28 | 482,039 | 4 |
| Antioch, CA | $28.30 | $0.00 – $271.73 | 481,971 | 6 |
| Rochester, MN | $161.27 | $13.02 – $2,014 | 481,555 | 43 |
| El Centro, CA | $43.00 | $0.07 – $218.69 | 480,847 | 4 |
| Wilson, NC | $125.52 | $26.85 – $171.38 | 477,537 | 5 |
| Albany, NY | $113.47 | $40.42 – $286.59 | 475,654 | 29 |
| Reseda, CA | $29.29 | $0.00 – $329.45 | 475,313 | 4 |
| Willimantic, CT | $21.29 | $3.69 – $176.12 | 468,783 | 10 |
| Las Cruces, NM | $30.66 | $0.00 – $139.95 | 467,826 | 16 |
| Wilmington, OH | $31.25 | $0.00 – $303.25 | 463,030 | 56 |
| Peekskill, NY | $41.31 | $41.31 – $41.31 | 459,426 | 1 |
| Medford, OR | $74.38 | $0.00 – $1,053 | 458,520 | 265 |
| Danville, VA | $38.55 | $10.63 – $326.51 | 457,502 | 18 |
| Newark, NJ | $117.53 | $0.00 – $1,280 | 456,003 | 17 |
| Fullerton, CA | $36.31 | $0.00 – $161.40 | 453,868 | 11 |
| Aberdeen, WA | $21.04 | $0.00 – $220.43 | 450,472 | 76 |
| Fond Du Lac, WI | $10.48 | $0.00 – $33.54 | 448,434 | 42 |
| Casa Grande, AZ | $82.65 | $0.00 – $1,474 | 446,418 | 34 |
| Tarzana, CA | $95.82 | $0.00 – $163.07 | 444,905 | 3 |
| Elkton, MD | $79.72 | $3.75 – $194.23 | 444,259 | 13 |
| Inglewood, CA | $51.03 | $0.00 – $103.43 | 438,063 | 10 |
| Yakima, WA | $33.50 | $0.00 – $1,096 | 433,781 | 170 |
| Pomona, CA | $64.29 | $0.00 – $276.94 | 429,941 | 32 |
| Battle Creek, MI | $32.97 | $6.50 – $98.20 | 429,029 | 5 |
| Kent, WA | $2.22 | $0.00 – $259.03 | 421,193 | 85 |
| Kingman, AZ | $22.76 | $0.00 – $55.86 | 418,512 | 11 |
| Waterville, ME | $95.95 | $0.00 – $2,801 | 414,652 | 110 |
| Muskegon, MI | $27.59 | $3.11 – $379.64 | 413,832 | 18 |
| Elizabethtown, KY | $86.14 | $0.00 – $144.70 | 411,305 | 36 |
| Warren, OH | $104.84 | $0.00 – $294.94 | 410,987 | 224 |
| Lodi, CA | $25.14 | $0.00 – $308.05 | 409,484 | 3 |
| Pasadena, CA | $65.64 | $0.00 – $194.86 | 408,555 | 32 |
| Monroe, LA | $131.19 | $0.00 – $353.95 | 408,318 | 85 |
| Laplace, LA | $8.96 | $8.31 – $12.91 | 407,215 | 2 |
| Shelbyville, KY | $48.11 | $25.52 – $265.19 | 404,550 | 8 |
| Lawrence, MA | $39.57 | $0.00 – $315.96 | 402,897 | 16 |
| Monroe, MI | $34.19 | $0.00 – $263.36 | 401,284 | 9 |
| Roseburg, OR | $25.62 | $0.00 – $1,934 | 399,450 | 114 |
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.