Addiction Medicine reimbursement rates by service line
Compare payer-published addiction medicine benchmarks for medication treatment; counseling; testing; office visits.
Compare national addiction medicine rates by payer
Use the reference codes to compare payer benchmarks, then explore medication treatment; counseling; testing; office visits. Each rate represents a specific billing code and comparison cohort, rather than a complete episode of care.
Aetna state variation for H0020
National H0020 rate distribution
Each marker shows the national median published rate across billing entities for that payer.
National H0020 rates by payer
| Payer | Rate period | Provider entities | P25 | Median | P75 | P90 | Average |
|---|---|---|---|---|---|---|---|
| Aetna | Jun–Jul 2026 | 835 | $19.11 | $24.23 | |||
| Cigna | Jun–Jul 2026 | 754 | $6.19 | $7.08 | |||
| United | Jun–Jul 2026 | 598 | $248.75 | $250.40 | |||
| Anthem | Jun–Jul 2026 | 884 | $19.80 | $30.38 |
- Source
- Negotiated or fee-schedule amounts published directly by payers in their machine-readable files.
- Rate shown
- Published commercial rate for alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) (H0020).
- Method
- Eligible rates are grouped by payer and billing entity so the benchmarks use a consistent service and billing basis.
The state map uses one consistent Aetna reference series; it does not average already-aggregated payer values. The service-line table keeps unlike codes, settings, and billing units in separate comparisons.
How do specific addiction medicine providers compare?
Compare named provider rates with the selected payer's median and percentile distribution.
National: Addiction Medicine provider benchmarks (HCPCS H0020)
| Provider entity | State | Size | $ per service | Gap to median | Position in Aetna range |
|---|---|---|---|---|---|
| CAMCARE HEALTH CORPORATIONNPI 1003846932 · Tax ID 222192716 | NJ | 183 | $16.33 | -$2.78 | Below P25 |
| PINE LAKE BEHAVIORAL HEALTH LLCNPI 1033208087 · Tax ID 824898393 | NE | 44 | Median to P75 | ||
| MAYIMRAPHA COMPREHENSIVE HEALTHCARE LLCNPI 1457639262 · Tax ID 452739248 | NM | 11 | Median to P75 | ||
| GLOBAL MEDICAL SERVICES OF GA LLCNPI 1821785726 · Tax ID 923557512 | GA | 10 | Median to P75 | ||
| RDK PAIN MANAGEMENT LLCNPI 1801881016 · Tax ID 461458559 | TX | 4 | Median to P75 | ||
| FAMILY WELLNESS AND AESTHETIC CENTER LLCNPI 1861717514 · Tax ID 831870617 | FL | 2 | Above P75 |
Choose one state to replace the mixed-state examples with payer-specific provider rates across all three preview codes.
No trial or data preparation required.Explore addiction medicine services
Compare codes within the same billing context. A reported billing unit may describe a timed service, supply quantity, daily service or procedure; it does not always mean one visit.
| Service line / billing code | Aetna | Cigna | United | Anthem |
|---|---|---|---|---|
$ per reported billing unit · 10 codes | ||||
S0109Methadone | $0.28 | $0.31 | $0.32 | $0.28 |
H0020Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | $24.23 | $7.08 | $250.40 | $30.38 |
H0004Behavioral health counseling and therapy | $15.73 | $11.34 | Not available | $26.59 |
H0005Alcohol and/or drug services; group counseling by a clinician | $22.07 | $5.58 | Not available | $23.59 |
H0047Alcohol and/or other drug abuse services | $183.83 | $291.99 | $1,537.23 | $0.01 |
H0006Alcohol and/or drug services; case management | $18.07 | $18.82 | Not available | $16.11 |
G9012Other specified case management service not elsewhere classified | $0.01 | $3.08 | Not available | $11.53 |
H0048Alcohol and/or other drug testing: collection and handling only | $6.27 | $1.32 | Not available | $3 |
T1016Case management | $11.44 | $50.60 | $12.73 | Not available |
H0002Behavioral health screening to determine eligibility for admission to treatment program | $60.08 | $10.99 | Not available | $23.23 |
$ per HCPCS drug unit · 3 codes | ||||
J0571Buprenorphine | $0.40 | $0.41 | $0.41 | $0.65 |
J0574Buprenorphine/naloxone | $7.62 | $11.44 | $11.16 | $7.52 |
J0572Buprenorphine/naloxone | $3.77 | $5.85 | $7.23 | $3.82 |
$ per reported billing unit · 2 codes | ||||
80305Presumptive drug testing by direct optical observation | $12.20 | $16.02 | $11.14 | $13 |
80307Presumptive drug testing by instrumented chemistry analysis | $61.05 | $75.48 | $55.80 | $63.68 |
$ per reported billing unit · 3 codes | ||||
99214Established patient office visit, level 4 | $110.62 | $151.85 | $153.85 | $144.65 |
99213Established patient office visit, level 3 | $75.90 | $103.44 | $106.99 | $103.22 |
99211Established patient office visit, minimal service | $18.82 | $25.63 | $30.73 | $27.43 |
$ per reported billing unit · 2 codes | ||||
90853Group psychotherapy (other than a multiple-family group) | $40.11 | $45.38 | $44.62 | $42.89 |
90832Psychotherapy, 30 minutes | $78.29 | $109.37 | $102.88 | $98.48 |
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Book a 20-min scoping call No trial or data preparation required.How to interpret these benchmarks
Payer-published rates provide market context. They do not establish a practice's contracted rate or the total cost of care.
- Source and periodRates come from the specialty's national report. The displayed period follows the processed data included in the latest published snapshot and updates when that snapshot is refreshed.
- Comparable ratesComparisons use positive professional fee-for-service negotiated and fee-schedule dollar amounts. Percentages, bundled arrangements and per-diem rate types are excluded. Modifier cohorts and code-specific amounts remain separate.
- CalculationRates are reduced to one modal value per NPI and TIN entity, averaging tied modes. Two percent per tail is targeted for trimming while keeping boundary ties. Benchmarks require at least 10 included entities and are not weighted by patient volume.
- CoverageNational report coverage does not guarantee every payer or state is available for every code. Anthem represents the displayed Anthem cohort, rather than all regional Blue plans. Missing benchmarks are not zero rates.
- Billing contextMatch the exact code, billing unit, modifier, setting and network. Equipment rentals and supplies require their own interval and quantity checks. Professional rates exclude facility charges; anesthesia conversion factors are outside these comparisons.
Get the addiction medicine reimbursement data you're looking for
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We'll tell you what the data can support, where the gaps are, and the clearest way to structure the comparison.
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Explore addiction medicine rates by state
Choose a state to compare payer reference averages for common services.
Questions about addiction medicine benchmarks
How to interpret the selected market and payer-published rates.
What does the national benchmark compare?
The headline uses Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) (H0020). The other reference codes and service lines provide separate comparisons rather than combining unlike services.
Why is a payer or state missing?
A benchmark appears only when the selected code and cohort meet the publication rules, including at least 10 entities after trimming. Report-wide coverage can be broader than an individual comparison.
Will the reporting period change?
Yes. The period displayed with the benchmark follows the processed source data when the publication snapshot is refreshed.