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 β $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 β 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 |
|---|---|---|---|---|
| Lakewood, CA | $0.00 | $0.00 β $0.00 | 1,212 | 2 |
| Deerfield, IL | $33.02 | $32.89 β $35.99 | 1,211 | 2 |
| Two Rivers, WI | $12.46 | $12.46 β $12.46 | 1,208 | 1 |
| Pigeon, MI | $66.88 | $66.88 β $66.88 | 1,208 | 1 |
| Valley Cottage, NY | $45.65 | $31.73 β $51.34 | 1,206 | 2 |
| Clatskanie, OR | $18.69 | $5.15 β $29.46 | 1,196 | 2 |
| Decherd, TN | $87.30 | $87.30 β $87.30 | 1,194 | 1 |
| Roslyn Heights, NY | $82.19 | $82.19 β $82.19 | 1,192 | 1 |
| Moberly, MO | $0.00 | $0.00 β $0.00 | 1,188 | 1 |
| Wauwatosa, WI | $93.24 | $7.15 β $151.74 | 1,185 | 13 |
| South Hill, VA | $173.61 | $173.61 β $173.61 | 1,183 | 1 |
| Owensville, IN | $346.03 | $346.03 β $346.03 | 1,182 | 1 |
| Barley, ID | $53.84 | $53.84 β $53.84 | 1,176 | 1 |
| Jonesville, VA | $302.88 | $105.08 β $335.49 | 1,173 | 2 |
| Fryeburg, ME | $91.30 | $91.30 β $91.30 | 1,164 | 1 |
| Fairfax, VT | $78.55 | $78.55 β $78.55 | 1,163 | 1 |
| Brush Prairie, WA | $76.45 | $76.45 β $76.45 | 1,163 | 1 |
| Milton, WA | $45.17 | $9.65 β $114.20 | 1,151 | 2 |
| Lakeside, AZ | $79.26 | $35.14 β $79.88 | 1,150 | 2 |
| Lyons Falls, NY | $55.80 | $55.80 β $55.80 | 1,149 | 1 |
| Iron River, WI | $9.66 | $9.66 β $9.66 | 1,149 | 1 |
| Adams, MA | $43.06 | $43.06 β $43.06 | 1,147 | 1 |
| Ash Flat, AR | $90.71 | $90.71 β $90.71 | 1,144 | 1 |
| Gardner, MA | $9.32 | $0.00 β $43.89 | 1,140 | 3 |
| Bowdoin, ME | $73.06 | $61.23 β $78.00 | 1,140 | 2 |
| Assumption, IL | $58.48 | $58.48 β $58.48 | 1,138 | 1 |
| Tamarac, FL | $222.40 | $222.40 β $222.40 | 1,133 | 1 |
| Dundee, FL | $9.58 | $1.29 β $13.80 | 1,133 | 4 |
| Tazewell, VA | $23.40 | $21.18 β $23.46 | 1,133 | 2 |
| Cairo, IL | $66.25 | $66.25 β $66.25 | 1,133 | 1 |
| North Richland Hills, TX | $59.95 | $59.95 β $59.95 | 1,133 | 1 |
| Chester, VT | $830.29 | $830.29 β $830.29 | 1,132 | 1 |
| Naytahwaush, MN | $477.20 | $477.20 β $477.20 | 1,130 | 1 |
| Fairfax, OK | $64.38 | $64.38 β $64.38 | 1,129 | 1 |
| S Yarmouth, MA | $16.01 | $16.01 β $16.01 | 1,127 | 1 |
| Country Club Hills, IL | $139.12 | $139.12 β $139.12 | 1,127 | 1 |
| Garnerville, NY | $34.99 | $34.99 β $34.99 | 1,125 | 1 |
| Liberty, MO | $59.58 | $59.58 β $59.58 | 1,122 | 1 |
| Arcadia, OH | $39.92 | $39.66 β $40.35 | 1,122 | 2 |
| North Highlands, CA | $8.38 | $8.38 β $8.38 | 1,121 | 1 |
| Mount Olive, NC | $144.60 | $144.60 β $144.60 | 1,121 | 1 |
| Phoenix, MD | $154.72 | $154.72 β $154.72 | 1,121 | 1 |
| Mountain Home Afb, ID | $43.31 | $43.31 β $43.31 | 1,121 | 1 |
| Orosi, CA | $11.17 | $11.17 β $11.17 | 1,118 | 1 |
| Snow Hill, NC | $138.82 | $0.00 β $142.14 | 1,115 | 2 |
| Richmond Hts, OH | $54.09 | $54.09 β $54.09 | 1,115 | 1 |
| Millersville, PA | $52.12 | $52.12 β $52.12 | 1,114 | 1 |
| Chestnut Hill, MA | $137.48 | $137.48 β $137.48 | 1,113 | 1 |
| Heath, OH | $30.31 | $30.31 β $30.31 | 1,112 | 1 |
| Placitas, NM | $161.53 | $161.53 β $161.53 | 1,112 | 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.