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 |
|---|---|---|---|---|
| Pagosa Springs, CO | $4.69 | $0.00 – $8.46 | 193 | 2 |
| Loxahatchee Groves, FL | $17.24 | $15.38 – $24.92 | 193 | 4 |
| Walls, MS | $256.84 | $256.84 – $256.84 | 193 | 1 |
| Buena Vista, GA | $0.00 | $0.00 – $0.00 | 192 | 1 |
| Woodmere, OH | $0.00 | $0.00 – $0.00 | 191 | 1 |
| Monroe, OR | $36.30 | $36.30 – $36.30 | 191 | 1 |
| Grandview, OH | $73.39 | $73.39 – $73.39 | 191 | 1 |
| Dover, NJ | $0.00 | $0.00 – $0.00 | 190 | 1 |
| Gary, WV | $0.30 | $0.30 – $0.30 | 190 | 1 |
| Tolleson, AZ | $0.00 | $0.00 – $0.00 | 190 | 1 |
| Bridgeport, MI | $5.42 | $5.42 – $5.42 | 189 | 1 |
| Jefferson Hills, PA | $0.00 | $0.00 – $0.00 | 187 | 1 |
| Lanse, MI | $0.00 | $0.00 – $0.00 | 187 | 1 |
| Raymore, MO | $0.00 | $0.00 – $0.00 | 186 | 2 |
| Barrington, RI | $9.19 | $9.19 – $9.19 | 185 | 1 |
| Poquoson, VA | $232.49 | $232.49 – $232.49 | 185 | 1 |
| Stonewall, LA | $99.94 | $99.94 – $99.94 | 185 | 1 |
| Valhalla, NY | $90.63 | $77.81 – $190.13 | 184 | 2 |
| Leesville, LA | $36.79 | $36.79 – $36.79 | 184 | 1 |
| Cody, WY | $75.81 | $0.00 – $102.57 | 184 | 2 |
| Philomath, OR | $40.61 | $40.61 – $40.61 | 184 | 1 |
| Vancouver, OR | $127.10 | $127.10 – $127.10 | 184 | 1 |
| Mullins, SC | $23.50 | $23.50 – $23.50 | 183 | 1 |
| Lake Forest, CA | $19.02 | $0.00 – $24.00 | 183 | 3 |
| Indian Trail, NC | $110.60 | $8.64 – $139.12 | 183 | 2 |
| Loma, CO | $78.98 | $78.98 – $78.98 | 183 | 1 |
| Saint Marys, OH | $39.80 | $31.16 – $44.46 | 182 | 3 |
| Hardin, MT | $0.00 | $0.00 – $0.00 | 182 | 2 |
| Peaks Island, ME | $115.65 | $115.65 – $115.65 | 182 | 1 |
| Kindred, ND | $94.80 | $94.80 – $94.80 | 180 | 1 |
| Vinton, VA | $22.63 | $22.63 – $22.63 | 179 | 1 |
| Celebration, FL | $274.04 | $14.03 – $901.57 | 179 | 5 |
| Hiram, GA | $34.90 | $34.90 – $34.90 | 179 | 1 |
| Iron, OH | $96.74 | $96.74 – $96.74 | 179 | 1 |
| Caseyville, IL | $104.38 | $59.77 – $114.61 | 177 | 2 |
| Mechanic Falls, ME | $77.18 | $77.18 – $77.18 | 177 | 1 |
| Palmetto Bay, FL | $27.52 | $27.52 – $27.52 | 176 | 1 |
| Fraser, MI | $192.99 | $192.99 – $192.99 | 176 | 1 |
| Whitefish Bay, WI | $21.44 | $21.44 – $21.44 | 176 | 1 |
| Carnegie, OK | $0.00 | $0.00 – $0.00 | 176 | 1 |
| Burtonsville, MD | $56.31 | $31.11 – $76.48 | 175 | 3 |
| White City, OR | $96.55 | $96.55 – $96.55 | 175 | 1 |
| Willoughby Hills, OH | $88.78 | $88.78 – $88.78 | 174 | 1 |
| Fort Riley, KS | $23.42 | $23.42 – $23.42 | 173 | 1 |
| Hartwell, GA | $24.06 | $24.06 – $24.06 | 173 | 1 |
| Douglas, WY | $155.18 | $57.39 – $172.59 | 172 | 2 |
| Harbor City, CA | $0.00 | $0.00 – $0.00 | 171 | 1 |
| Cape Elizabeth, ME | $70.15 | $70.15 – $70.15 | 171 | 1 |
| Macon, MO | $0.00 | $0.00 – $0.00 | 169 | 1 |
| Little Neck, NY | $7.28 | $7.28 – $7.28 | 169 | 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.