Opioid treatment: methadone administration: Medicaid rates by state

A billing code alone doesn't make a fair comparison: states bill opioid treatment: methadone administration under different codes, units and provider types. This benchmark lines up one comparable rate per state.

• Provider level. States are compared at the physician or licensed psychologist (incl. BCBA-D) level. Rates for other levels on file (any qualified provider, clinical nurse specialist, licensed practical / vocational nurse and registered nurse) are kept separate, never mixed into this ranking.
• Unit. Of the 13 states, 3 publish their headline rate per day, 1 per two weeks (8 - 14 days), 1 per weekly and 2 in other units, and 6 schedules print no unit at all (a flat amount per service). The ranking uses the rate as published, so read the unit before comparing two states.
• Variants. 7 of the 13 states publish more than one rate for this service (by modifier, program, setting or provider type); the headline rate is the one that matches the comparison, and the workspace lists every variant.
• Depth. 683 rates for this service are on file across all states, versions and provider levels; this page shows one headline rate per state.

The highest-paying state, Ohio, pays $258.56; the lowest, Arizona, pays $5.93, a 43.6x gap. 13 of the 13 states pay above the median of —. Common reasons rates for behavioral health services spread this way:

• Many states pay behavioral health services differently by the practitioner's credential, from psychiatrist and psychologist to licensed clinical social worker, counselor and peer specialist.
• States add enhanced rates for crisis services, certified community behavioral health clinics and integrated care that sit outside the base schedule.
• Community mental health and substance use services are often billed under H and T codes that each state defines for itself, so the same code can describe a different service in two states.

Billing notes

Modifiers such as HO (master's level), HN (bachelor's level) and HP (doctoral level) identify the practitioner, and many states publish a different rate for each. Psychotherapy codes are defined by session length, so one unit is one session of the stated duration; H codes are billed in whatever unit the state defines, often 15 minutes, an hour or a day.