H2036
Alcohol/drug treatment, per hour
Alcohol/drug treatment, per hour is the #41 most-billed Medicaid procedure code, with $4.70B in payments across 18.2M claims from 2018–2024. The national median cost per claim is $253.79. Costs vary widely — the 90th percentile is $1,384.74 per claim, 5.5× the median.
Total Paid
$4.70B
0.43% of all spending
Total Claims
18.2M
Providers
976
Avg Cost/Claim
$258
National Cost Distribution
How much do providers bill per claim for H2036? Based on 956 providers billing this code nationally.
Median
$253.79
Average
$594.37
Std Dev
$1,121.45
Max
$10,636.26
Percentile Distribution (Cost per Claim)
50% of providers bill between $161.87 and $419.23 per claim for this code.
90% bill between $82.73 and $1,384.74.
Top 1% bill above $5,767.32.
About This Procedure
HCPCS code H2036 (Alcohol/drug treatment, per hour) was billed by 976 providers across 18.2M claims, totaling $4.70B in Medicaid payments from 2018–2024. This code was used for 1.5M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$253.79
Providers Billing
956
National Spending
$4.70B
Avg/Median Ratio
2.34×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for H2036
| # | Provider | Total Paid |
|---|---|---|
| 1 | Pyramid Health Care Inc. Wilkinsburg, PA · Substance Abuse Rehabilitation Facility | $101.6M |
| 2 | White Deer Run Llc Allenwood, PA · Community/Behavioral Health | $87.1M |
| 3 | 1053648774 | $76.8M |
| 4 | State Of Missouri Jefferson City, MO · Counselor, Addiction (Substance Use Disorder) | $59.9M |
| 5 | Corecare Behavioral Health Management Inc. Philadelphia, PA · Substance Abuse Rehabilitation Facility | $57.4M |
| 6 | Samaritan Daytop Village Inc. Richmond Hill, NY · Substance Abuse Rehabilitation Facility | $56.6M |
| 7 | 1477615656 | $55.2M |
| 8 | Malvern Institute For Psychiatric And Alcoholic Studies Inc. Malvern, PA · Special Hospital | $55.1M |
| 9 | 1043560808 | $53.1M |
| 10 | 1174691281 | $50.4M |
| 11 | 1093970881 | $42.6M |
| 12 | Gateway Rehabilitation Center Mt Pleasant, PA · Substance Abuse Rehabilitation Facility | $38.5M |
| 13 | 1134788797 | $38.5M |
| 14 | 1366820706 | $38.2M |
| 15 | 1487192712 | $34.7M |
| 16 | 1174021406 | $33.8M |
| 17 | 1922368166 | $32.9M |
| 18 | 1700290301 | $32.7M |
| 19 | 1043780851 | $31.3M |
| 20 | 1922180652 | $31.0M |
Showing top 20 of 976 providers billing this code