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 |
|---|---|---|---|---|
| Waverly, OH | $94.71 | $11.26 – $267.60 | 270,273 | 158 |
| Morgantown, WV | $159.08 | $0.00 – $264.86 | 269,823 | 12 |
| Berkeley, CA | $34.05 | $0.00 – $230.00 | 269,177 | 6 |
| Coeur D Alene, ID | $145.14 | $0.00 – $441.50 | 267,819 | 29 |
| Largo, MD | $9.12 | $0.00 – $171.85 | 267,239 | 6 |
| Escondido, CA | $86.46 | $0.00 – $345.79 | 266,008 | 27 |
| Santa Rosa, CA | $71.21 | $0.00 – $145.65 | 265,758 | 24 |
| Watsonville, CA | $20.35 | $0.00 – $209.28 | 265,540 | 14 |
| Edmond, OK | $66.31 | $0.00 – $94.74 | 264,781 | 161 |
| Rio Rancho, NM | $127.50 | $0.00 – $235.79 | 263,531 | 38 |
| Marion, OH | $64.83 | $0.00 – $300.20 | 262,513 | 120 |
| Kinston, NC | $221.99 | $185.60 – $247.21 | 262,229 | 4 |
| Warwick, RI | $71.84 | $0.00 – $243.33 | 262,030 | 18 |
| Orem, UT | $15.84 | $10.96 – $108.83 | 261,285 | 8 |
| Edgewood, MD | $97.94 | $46.79 – $208.78 | 261,273 | 9 |
| Norwood, MA | $53.46 | $53.46 – $53.46 | 257,195 | 1 |
| Pineville, LA | $107.97 | $15.00 – $145.12 | 253,569 | 11 |
| Irvington, NJ | $60.95 | $31.58 – $111.23 | 253,517 | 12 |
| Wheeling, WV | $104.80 | $0.00 – $197.84 | 253,274 | 9 |
| Eureka, CA | $59.41 | $0.00 – $282.29 | 252,380 | 49 |
| Chaska, MN | $197.32 | $26.64 – $205.11 | 251,789 | 3 |
| Richmond, KY | $84.59 | $0.00 – $232.10 | 250,705 | 20 |
| Poteau, OK | $68.24 | $21.53 – $74.84 | 250,095 | 66 |
| Lima, OH | $85.46 | $0.00 – $342.18 | 248,726 | 145 |
| Port Angeles, WA | $11.94 | $0.00 – $154.08 | 247,761 | 71 |
| Springfield, OH | $104.78 | $0.00 – $285.97 | 247,438 | 124 |
| Glendale, CA | $19.70 | $0.00 – $185.83 | 247,380 | 10 |
| Carmel, NY | $36.81 | $18.87 – $107.97 | 247,092 | 14 |
| La Puente, CA | $21.20 | $0.00 – $463.54 | 245,391 | 4 |
| Traverse City, MI | $14.18 | $2.71 – $207.32 | 245,317 | 7 |
| Salisbury, NC | $120.71 | $15.64 – $195.46 | 244,156 | 7 |
| Martinsville, VA | $157.24 | $1.42 – $316.06 | 243,861 | 8 |
| Bel Air, MD | $138.82 | $0.38 – $299.93 | 242,813 | 11 |
| Knoxville, TN | $102.27 | $0.00 – $310.00 | 239,535 | 47 |
| Lawton, OK | $63.76 | $0.00 – $75.42 | 239,086 | 126 |
| Xenia, OH | $142.66 | $3.49 – $288.21 | 235,234 | 134 |
| Yanceyville, NC | $162.52 | $90.99 – $164.76 | 234,926 | 3 |
| Brighton, MA | $31.72 | $31.21 – $297.85 | 234,650 | 7 |
| Savannah, GA | $18.92 | $0.00 – $177.17 | 234,497 | 7 |
| Brentwood, NY | $214.22 | $214.22 – $214.22 | 234,435 | 1 |
| Circleville, OH | $95.97 | $5.19 – $212.85 | 233,777 | 110 |
| Annapolis, MD | $77.62 | $45.02 – $124.61 | 233,481 | 11 |
| Fargo, ND | $55.65 | $0.00 – $1,191 | 231,847 | 76 |
| Greeley, CO | $152.57 | $0.00 – $451.07 | 231,309 | 58 |
| Elyria, OH | $66.92 | $14.47 – $279.29 | 231,053 | 61 |
| Ardmore, OK | $62.93 | $0.00 – $73.92 | 230,453 | 87 |
| Roseville, MN | $19.92 | $0.78 – $140.05 | 229,323 | 5 |
| Wichita, KS | $69.16 | $0.00 – $238.43 | 228,961 | 28 |
| Nashville, TN | $72.88 | $0.00 – $302.34 | 228,351 | 49 |
| Sorrento, LA | $117.77 | $116.38 – $125.60 | 228,045 | 2 |
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.