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 |
|---|---|---|---|---|
| Glen Mills, PA | $0.10 | $0.10 – $0.10 | 227,849 | 1 |
| Flagstaff, AZ | $108.70 | $0.00 – $351.47 | 227,260 | 27 |
| Jacksonville, FL | $58.70 | $0.00 – $446.80 | 226,604 | 41 |
| Martinsburg, WV | $79.49 | $0.00 – $172.43 | 226,446 | 11 |
| Quincy, MA | $60.61 | $43.10 – $242.03 | 226,113 | 5 |
| Pikeville, KY | $43.54 | $0.00 – $86.81 | 225,767 | 19 |
| Redlands, CA | $23.46 | $0.00 – $69.37 | 225,728 | 26 |
| Atascadero, CA | $63.02 | $6.23 – $117.64 | 224,721 | 4 |
| Peoria, AZ | $50.58 | $0.00 – $1,699 | 224,462 | 26 |
| Bloomington, MN | $66.26 | $14.13 – $200.26 | 223,879 | 7 |
| Henderson, NC | $51.81 | $4.52 – $170.03 | 223,793 | 9 |
| Merced, CA | $85.66 | $17.02 – $303.73 | 223,627 | 9 |
| Lewiston, ME | $84.20 | $0.00 – $235.04 | 222,982 | 121 |
| Porterville, CA | $24.59 | $0.03 – $146.55 | 222,559 | 4 |
| Schenectady, NY | $67.20 | $3.24 – $196.59 | 222,483 | 9 |
| Mount Pleasant, WI | $11.81 | $7.59 – $45.77 | 221,842 | 34 |
| Monroe, NC | $116.93 | $50.21 – $146.36 | 221,774 | 4 |
| Durant, OK | $67.13 | $0.00 – $75.52 | 221,296 | 84 |
| El Monte, CA | $46.78 | $0.00 – $281.89 | 218,709 | 6 |
| Hillsboro, OR | $52.16 | $0.00 – $809.29 | 216,948 | 98 |
| Portsmouth, VA | $113.38 | $24.45 – $378.91 | 215,486 | 6 |
| Wasilla, AK | $162.65 | $0.00 – $1,060 | 214,894 | 56 |
| Claymont, DE | $5.25 | $0.00 – $12.30 | 214,762 | 3 |
| Westminster, CO | $176.52 | $0.00 – $773.26 | 214,537 | 25 |
| Oxford, AL | $23.09 | $23.09 – $23.09 | 213,371 | 1 |
| Rockford, IL | $77.00 | $27.53 – $122.19 | 213,322 | 18 |
| Lenoir, NC | $43.23 | $10.71 – $125.34 | 213,078 | 5 |
| Clinton, IN | $17.42 | $17.42 – $17.42 | 212,775 | 1 |
| Dundalk, MD | $114.13 | $68.77 – $306.87 | 212,385 | 11 |
| Blacksburg, VA | $335.91 | $14.71 – $336.48 | 211,673 | 13 |
| Pittsfield, MA | $131.70 | $0.00 – $617.27 | 211,387 | 23 |
| Fort Collins, CO | $105.73 | $0.00 – $2,192 | 211,215 | 87 |
| Johnston, RI | $61.16 | $0.00 – $150.50 | 210,965 | 9 |
| Bellingham, WA | $29.61 | $0.00 – $263.89 | 210,770 | 119 |
| Peabody, MA | $86.21 | $53.46 – $222.99 | 209,938 | 4 |
| Metairie, LA | $95.30 | $0.68 – $301.30 | 209,329 | 19 |
| Clarksburg, WV | $86.13 | $0.00 – $135.12 | 207,008 | 8 |
| Fremont, OH | $153.63 | $24.60 – $184.12 | 206,208 | 23 |
| Elmhurst, NY | $28.14 | $0.00 – $50.15 | 205,988 | 31 |
| East Meadow, NY | $27.00 | $0.00 – $28.54 | 205,820 | 9 |
| Athens, OH | $90.89 | $0.00 – $260.65 | 205,739 | 84 |
| Tigard, OR | $53.82 | $0.00 – $368.26 | 205,570 | 114 |
| Canton, OH | $123.28 | $0.00 – $332.74 | 205,448 | 145 |
| Saco, ME | $78.28 | $0.00 – $343.71 | 205,073 | 143 |
| Skokie, IL | $86.58 | $21.92 – $131.38 | 203,131 | 9 |
| Tampa, FL | $68.43 | $0.00 – $128.04 | 203,107 | 47 |
| Noblesville, IN | $133.80 | $34.68 – $397.55 | 202,849 | 5 |
| Longview, WA | $103.43 | $0.00 – $270.11 | 202,821 | 208 |
| Vista, CA | $143.60 | $0.00 – $223.49 | 202,808 | 11 |
| Abingdon, VA | $217.50 | $2.32 – $286.51 | 202,489 | 21 |
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.