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 |
|---|---|---|---|---|
| Hales Corners, WI | $37.53 | $37.53 – $37.53 | 1,536 | 1 |
| Heyburn, ID | $52.68 | $52.40 – $55.53 | 1,532 | 2 |
| Middleport, OH | $33.14 | $24.76 – $35.24 | 1,530 | 2 |
| Zephyrhills, FL | $0.00 | $0.00 – $0.01 | 1,529 | 4 |
| Chiloquin, OR | $492.82 | $492.82 – $492.82 | 1,529 | 1 |
| Springfield, ME | $1,375 | $1,375 – $1,375 | 1,527 | 1 |
| Bedford Heights, OH | $106.08 | $58.70 – $115.69 | 1,525 | 2 |
| Frankfort, OH | $141.91 | $141.91 – $141.91 | 1,519 | 1 |
| Allegan, MI | $640.64 | $640.64 – $640.64 | 1,515 | 1 |
| Magnolia, AR | $87.30 | $54.68 – $95.19 | 1,508 | 4 |
| Independence, OH | $104.48 | $19.36 – $240.48 | 1,506 | 8 |
| Chicopee, MA | $45.26 | $9.48 – $70.37 | 1,504 | 9 |
| Sedro Woolley, WA | $101.07 | $0.00 – $178.68 | 1,502 | 8 |
| South Portsmouth, KY | $190.60 | $190.60 – $190.60 | 1,501 | 1 |
| Mckinney, TX | $329.73 | $49.04 – $738.50 | 1,491 | 2 |
| Lihue, HI | $16.85 | $0.00 – $76.07 | 1,490 | 2 |
| Leesburg, FL | $43.19 | $0.24 – $62.65 | 1,490 | 4 |
| Tustin, CA | $0.02 | $0.00 – $0.08 | 1,487 | 6 |
| Taylorville, IL | $59.25 | $59.25 – $59.25 | 1,484 | 1 |
| Soper, OK | $75.38 | $75.38 – $75.38 | 1,482 | 1 |
| Clarksdale, MS | $21.97 | $0.00 – $22.17 | 1,481 | 2 |
| Whitesboro, NY | $35.59 | $8.23 – $36.12 | 1,481 | 2 |
| Oh, OH | $192.62 | $192.62 – $192.62 | 1,480 | 1 |
| Bulls Gap, TN | $229.19 | $229.19 – $229.19 | 1,479 | 1 |
| Lucasville, OH | $73.76 | $73.76 – $73.76 | 1,479 | 1 |
| Spring Lake, MI | $55.45 | $55.45 – $55.45 | 1,474 | 1 |
| Newfane, NY | $10.75 | $10.75 – $10.75 | 1,473 | 1 |
| Darlington, WI | $71.43 | $71.43 – $71.43 | 1,468 | 1 |
| Alvin, TX | $57.57 | $57.57 – $57.57 | 1,466 | 1 |
| Webster City, IA | $55.36 | $55.36 – $55.36 | 1,460 | 1 |
| Kearney, NE | $47.31 | $37.15 – $50.76 | 1,455 | 3 |
| Ferriday, LA | $105.83 | $90.44 – $134.39 | 1,450 | 2 |
| Mount Sterling, IL | $51.44 | $49.26 – $52.43 | 1,450 | 2 |
| Millinocket, ME | $99.80 | $39.42 – $100.60 | 1,447 | 2 |
| Bethel, ME | $97.37 | $90.11 – $129.16 | 1,447 | 2 |
| Kings Bay, GA | $57.54 | $57.54 – $57.54 | 1,443 | 1 |
| Flanders, NJ | $37.90 | $37.71 – $38.84 | 1,440 | 2 |
| Rainier, OR | $135.57 | $0.00 – $187.89 | 1,440 | 2 |
| Bisbee, AZ | $46.82 | $29.85 – $98.85 | 1,439 | 2 |
| Spring Hill, TN | $254.89 | $16.62 – $293.00 | 1,438 | 3 |
| Mount Juliet, TN | $37.80 | $7.80 – $74.69 | 1,434 | 2 |
| Douglas, GA | $54.75 | $54.75 – $54.75 | 1,434 | 1 |
| Del Valle, TX | $62.18 | $62.18 – $62.18 | 1,432 | 1 |
| Saunderstown, RI | $42.74 | $42.74 – $42.74 | 1,431 | 1 |
| Neah Bay, WA | $54.23 | $54.23 – $54.23 | 1,428 | 1 |
| Jerome, ID | $71.99 | $68.93 – $74.11 | 1,428 | 2 |
| Denton, TX | $123.69 | $66.33 – $128.74 | 1,426 | 3 |
| Bennettsville, SC | $78.41 | $78.41 – $78.41 | 1,426 | 1 |
| Freeport, ME | $76.62 | $54.25 – $102.22 | 1,426 | 6 |
| Rochelle, GA | $0.00 | $0.00 – $0.00 | 1,425 | 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.