Behavioral Health Facilities reimbursement rates by service line
Compare national behavioral health facilities reimbursement benchmarks calculated from price transparency data. Reference benchmarks cover H0015, H0035 and H2036 across Aetna, Anthem, Cigna and United. Reporting periods: Aug–Dec 2023, Jan–May 2026.
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Compare national behavioral health facility rates by payer
Compare facility and program rates by level of care without forcing revenue codes, HCPCS services, and inpatient case rates into one unit.
Aetna state variation for H0015
National H0015 rate distribution
Each marker shows the national median published rate across billing entities for that payer.
National H0015 rates by payer
| Payer | Rate period | Provider entities | P25 | Median | P75 | P90 | Average |
|---|---|---|---|---|---|---|---|
| Aetna | Aug–Dec 2023, Jan–May 2026 | 12,562 | $134.33 | $155.02 | |||
| Cigna | Aug–Dec 2023, Jan–May 2026 | 3,107 | $232 | $233.80 | |||
| United | Aug–Dec 2023, Jan–May 2026 | 10 | $128.50 | $136.83 | |||
| Anthem | Aug–Dec 2023, Jan–May 2026 | 171 | $157.50 | $168.60 |
- Source
- Negotiated or fee-schedule amounts published directly by payers in their machine-readable files.
- Rate shown
- Published commercial rate for intensive outpatient treatment (H0015).
- 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.
Confirm coverage for your codes, payers and markets.
How do specific behavioral health facilities compare?
Compare named provider rates with the selected payer's median and percentile distribution.
National: Behavioral health facility rates by payer (HCPCS H0015)
| Provider entity | State | Size | $ per reported unit | Gap to median | Position in Aetna range |
|---|---|---|---|---|---|
| VISION LOSS ALLIANCE OF NEW JERSEYNPI 1003361775 · Tax ID 221592609 | NJ | 13 | $62.88 | -$71.45 | Below P25 |
| ENSO PSYCH GROUP LLCNPI 1265683551 · Tax ID 208187316 | FL | 8 | $121.05 | -$13.28 | Below P25 |
| PHILLY PREGNANCY CENTER PCNPI 1184954505 · Tax ID 270309719 | PA | 2 | $134.33 | +$0 | Median to P75 |
| IMAGINE MORE COUNSELING SOLUTIONS LLCNPI 1598346561 · Tax ID 862603442 | IL | 2 | $134.33 | +$0 | Median to P75 |
| A BETTER YOU COUNSELING WELLNESS LLCNPI 1992302830 · Tax ID 851365677 | PA | 8 | $134.33 | +$0 | Median to P75 |
| BOCA RI LLCNPI 1932631827 · Tax ID 815056602 | FL | 20 | Above P75 |
Choose one state to replace the mixed-state examples with payer-specific provider rates for available preview codes.
No trial or data preparation required.Which providers have the highest claim volume in the behavioral health facilities market?
Provider organizations with the highest combined 2024 Medicare and Medicaid claim volume in the behavioral health facilities market.
- 1OHMaryhaven INC.NPI 1922368166Medicare 35,798Medicaid 12,01747,815 total
- 2OHLandmark Recovery Of Ohio LLCNPI 1346843810Medicare 20,690Medicaid 13,44934,139 total
- 3NYRestorative Management CORPNPI 1043385578Medicare 31,641Medicaid 531,646 total
- 4KYLandmark Recovery Of Kentucky LLCNPI 1326630484Medicare 28,861Medicaid 028,861 total
- 5NMSanta Fe Recovery Center INCNPI 1447265160Medicare 7,916Medicaid 20,06127,977 total
- 6WVChildren's Home Society Of West VirginiaNPI 1598884488Medicare 18,269Medicaid 018,269 total
- 7KYAddiction Recovery Care LLCNPI 1730421553Medicare 17,410Medicaid 017,410 total
- 8LAWoodlake Management LLCNPI 1053648774Medicare 14,216Medicaid 014,216 total
- 9OHHealthy Living Treatment LLCNPI 1174987887Medicare 11,048Medicaid 1,70812,756 total
- 10MNMinnesota Teen Challenge INCNPI 1194802710Medicare 11,330Medicaid 011,330 total
- 11WAHolman Recovery CenterNPI 1437738044Medicare 7,000Medicaid 4,12211,122 total
- 12LAPathways Substance Abuse LLCNPI 1578117297Medicare 10,157Medicaid 40510,562 total
- 13VAAnderson Associates LLCNPI 1033631585Medicare 10,001Medicaid 9610,097 total
- 14NHLive Free Recovery Services LLCNPI 1205461886Medicare 7,772Medicaid 1,2909,062 total
- 15LASerenity Treatment Center Of LNPI 1629633193Medicare 9,038Medicaid 09,038 total
- 16INLandmark Recovery Of Carmel LLCNPI 1710511068Medicare 7,188Medicaid 1,2718,459 total
- 17WVCharles W. Cammack Children's Center Inc.NPI 1104086503Medicare 8,053Medicaid 08,053 total
- 18NJRescue Mission Of TrentonNPI 1376936641Medicare 0Medicaid 7,9297,929 total
- 19LASteps Recovery Solutions LLCNPI 1841958188Medicare 7,407Medicaid 07,407 total
- 20LAOdyssey House Louisiana INCNPI 1134788797Medicare 7,135Medicaid 07,135 total
How reimbursement changes by behavioral health level of care
Keep withdrawal management, intensive outpatient, partial hospitalization, residential treatment, revenue-code services, and inpatient cases in their appropriate payment units.
| Service line / billing code | Aetna | Cigna | United | Anthem |
|---|---|---|---|---|
$ per reported unit · 7 codes | ||||
H0008Sub-acute detoxification, hospital inpatient | $289.03 | Not available | Not available | Not available |
H0009Acute detoxification, hospital inpatient | $339.08 | Not available | Not available | Not available |
H0010Sub-acute detoxification, residential inpatient | $264.60 | $197.88 | $833.35 | $636.68 |
H0011Acute detoxification, residential inpatient | $374.18 | $329.21 | $802.95 | $519.14 |
H0012Sub-acute detoxification, residential outpatient | $70.19 | Not available | Not available | Not available |
H0013Acute detoxification, residential outpatient | $429.28 | Not available | Not available | Not available |
H0014Ambulatory detoxification | $173.17 | $317.46 | Not available | $243.85 |
$ per reported unit · 4 codes | ||||
H0015Substance-use intensive outpatient treatment | $155.02 | $233.80 | $136.83 | $168.60 |
H0035Mental health partial hospitalization, less than 24 hours | $281.65 | $610.27 | Not available | $376.88 |
S0201Partial hospitalization services, per diem | $279.28 | $581.34 | Not available | $506.59 |
S9480Intensive outpatient psychiatric services, per diem | $109.10 | $268.31 | Not available | $253.16 |
$ per reported unit · 4 codes | ||||
H0017Hospital residential behavioral health treatment, per diem | $668.31 | $282.15 | Not available | Not available |
H0018Short-term non-hospital residential treatment, per diem | $315.47 | $484.93 | Not available | $586.52 |
H0019Long-term non-hospital residential treatment, per diem | $212.94 | $411.62 | Not available | Not available |
H2036Alcohol or drug treatment program, per diem | $357.83 | $228.40 | Not available | $349.84 |
$ per reported unit · 8 codes | ||||
0905Psychiatric intensive outpatient services | $245.14 | $266.25 | $265.24 | $289.67 |
0906Chemical-dependency intensive outpatient services | $241.56 | $232.42 | $220.42 | $252.77 |
0912Partial hospitalization, less intensive | $449.93 | $432.45 | $410.30 | $493.13 |
0913Partial hospitalization, intensive | $450.31 | $427.59 | $433.89 | $532.44 |
0914Individual behavioral health therapy | $149.46 | $177.89 | Not available | $304.35 |
0915Group behavioral health therapy | $213.51 | $88.56 | Not available | $283.99 |
0944Drug rehabilitation | $347.84 | $133.12 | $212.37 | $297.37 |
0945Alcohol rehabilitation | $348.69 | $135.86 | $232.07 | $360.55 |
$ per case · 7 codes | ||||
880Acute adjustment reaction and psychosocial dysfunction | $15,843.41 | $16,018.35 | $16,114.77 | $3,140.46 |
881Depressive neuroses | $15,444.03 | $15,197.24 | $15,777.58 | $3,088.58 |
885Psychoses | $22,808 | $23,078.82 | $22,895.88 | $3,725.36 |
894Alcohol or drug dependence, left against medical advice | $10,281.52 | $9,985.71 | $10,779.23 | $2,779.13 |
895Alcohol or drug dependence with rehabilitation therapy | $24,149.22 | $26,775.17 | $23,523.40 | $4,595.36 |
896Alcohol or drug dependence without rehabilitation, with MCC | $28,890.92 | $30,406.48 | $28,478.73 | $5,206.13 |
897Alcohol or drug dependence without rehabilitation, without MCC | $14,659.13 | $14,787.84 | $14,935.85 | $3,335.40 |
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Book a 20-min scoping call No trial or data preparation required.How to read these behavioral health facilities rates
Benchmarks calculated by PayerPrice from health plan price transparency files. CMS price transparency requirements.
- Published rates, not paymentsThese figures summarize negotiated rates reported by health plans. They are not claim payments, patient prices or a provider's verified contract.
- Average vs. medianThe average combines eligible billing-entity rates; the median is the middle rate. A large gap between them can signal that high or low rates are pulling the average.
- What a provider row meansA billing entity may be a clinician, practice, facility or health system. A named row does not always represent one individual provider.
- Compare like for likeMatch the code, billing component, setting, payment unit, network and reporting period. Facility, drug and other service payments may be separate.
Calculation details and specialty-specific notes
We start with negotiated or fee-schedule rates published in payer machine-readable files and included in the underlying behavioral health facility report. For each selected code, eligible records are grouped by payer and summarized as averages and percentile distributions.
- Rate source
- The displayed amount is a negotiated facility or program rate published in a payer machine-readable file, not a paid claim, billed charge, or utilization-based estimate.
- Rate calculation
- National values summarize eligible published records across available states. State views use records associated with the selected state, and averages are not weighted by patient or service volume. The calculation targets the lowest and highest 2% of entity rates for removal, rounded down to whole entities. Tied boundary values stay together, so fewer rates may be removed. A payer, code and geography cohort is published only when at least 10 billing entities remain after trimming. A missing benchmark does not mean the rate is zero.
- Provider entity
- Named examples use payer-file billing entities and may represent a treatment facility, operating organization, health system, or other contracted entity. Each NPI and TIN combination contributes one representative rate: its most frequent normalized value. When multiple values are equally frequent, those values are averaged.
- Comparable rates
- Match the level of care, code system, program definition, setting, payment unit, payer product, and network. Per-service, per-diem, and inpatient case rates should remain separate. Benchmarks keep the payer, service code, geography, reporting period and billing unit separate. Different services or payment units are not blended into one rate.
Compare Behavioral Health Facilities rates in your market
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- Define the scopeChoose the codes, payers, networks and providers.
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Explore behavioral health facilities rates by state
Choose a state to compare payer reference averages for common services.
How to interpret behavioral health facility rates
How to interpret the selected market and payer-published rates.
Which behavioral health facility services are represented?
The report includes HCPCS treatment codes, behavioral health revenue codes, selected MS-DRGs, and market-specific local codes.
Can per-diem and per-service rates be combined?
No. Residential, partial hospitalization, intensive outpatient, and inpatient services can use different units and payment structures.
Are these physician professional rates?
No. This page is designed around behavioral health facility and program reimbursement rather than physician-group professional services.
Which details make two behavioral health facility rates comparable?
Confirm the level of care, code system, program definition, patient population, setting, payment unit, payer product, and network before comparing two published rates.
How are named behavioral health facilities selected?
Provider examples are sampled across each payer's published rate range. Named examples may represent a facility, treatment organization, health system, or other billing entity. The national overview includes public provider samples; state provider-level comparisons require a free state preview.