H0020
Alcohol/drug services; methadone administration
Alcohol/drug services; methadone administration is the #28 most-billed Medicaid procedure code, with $6.25B in payments across 312.3M claims from 2018–2024. The national median cost per claim is $18.95. Costs vary widely — the 90th percentile is $99.16 per claim, 5.2× the median.
Total Paid
$6.25B
0.57% of all spending
Total Claims
312.3M
Providers
2K
Avg Cost/Claim
$20
National Cost Distribution
How much do providers bill per claim for H0020? Based on 2K providers billing this code nationally.
Median
$18.95
Average
$45.65
Std Dev
$69.25
Max
$859.40
Percentile Distribution (Cost per Claim)
50% of providers bill between $11.60 and $66.42 per claim for this code.
90% bill between $7.09 and $99.16.
Top 1% bill above $400.00.
About This Procedure
HCPCS code H0020 (Alcohol/drug services; methadone administration) was billed by 2K providers across 312.3M claims, totaling $6.25B in Medicaid payments from 2018–2024. This code was used for 22.5M unique beneficiaries.
Fraud Risk Context
Substance abuse treatment codes have seen increased scrutiny due to patient brokering and sober home schemes.
Source: HHS OIG & DOJ Enforcement Actions
Risk Assessment
Billing Statistics
Median Cost/Claim
$18.95
Providers Billing
2K
National Spending
$6.25B
Avg/Median Ratio
2.41×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for H0020
| # | Provider | Total Paid |
|---|---|---|
| 1 | Hartford Dispensary Hartford, CT · Clinic/Center, Methadone Clinic | $122.6M |
| 2 | Habit Opco, Llc Springfield, MA · Case Management | $117.7M |
| 3 | Los Angeles County Department Of Public Health Alhambra, CA · Public Health or Welfare | $103.1M |
| 4 | Spectrum Health Systems, Inc Worcester, MA · Clinic/Center, Rehabilitation, Substance Use Disorder | $92.1M |
| 5 | County Of Sacramento Sacramento, CA · Community/Behavioral Health | $77.2M |
| 6 | Community Health Care, Inc. Westfield, MA · Counselor, Addiction (Substance Use Disorder) | $70.6M |
| 7 | County Of San Diego San Diego, CA · Public Health or Welfare | $67.9M |
| 8 | Alabama Department Of Mental Health And Mental Retardation Montgomery, AL · Community/Behavioral Health | $64.8M |
| 9 | 1912155516 | $55.8M |
| 10 | Department Of Behavioral Health Fresno, CA · Social Worker, Clinical | $45.6M |
| 11 | City & County Of San Francisco San Francisco, CA · Community/Behavioral Health | $45.2M |
| 12 | Southeast Alaska Regional Health Consortium Juneau, AK · Community/Behavioral Health | $44.6M |
| 13 | 1649631086 | $40.6M |
| 14 | 1376712786 | $39.0M |
| 15 | San Joaquin Behavioral Health Services Stockton, CA · Counselor, Addiction (Substance Use Disorder) | $39.0M |
| 16 | 1407830946 | $38.8M |
| 17 | Alameda County Behavioral Health Care Oakland, CA · Community/Behavioral Health | $37.3M |
| 18 | 1851513394 | $37.3M |
| 19 | County Of Riverside Riverside, CA · Community/Behavioral Health | $36.6M |
| 20 | 1073679445 | $36.2M |
Showing top 20 of 2K providers billing this code