H2036 Medicaid reimbursement rates by state
Alcohol and/or other drug treatment program, per diem. 12 state Medicaid programs publish a fee-for-service rate for H2036 at the agency level. Rates run from $14.20 in Washington to $667.22 in Massachusetts, with a median of $241.24.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 12
- Median rate
- $241.24per day
- Highest
- $667.22Massachusetts
- Medicare (non-facility)
- —not on the physician fee schedule
H2036 rate in every state
One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $667.22since 2025-07-01 | day | — | Plans must pay at least this | — | Rates for Certain Substance Use Disorder |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $519.97since 2025-07-01 | day | — | Plans negotiate; applies out of network | — | HFS Fee Schedule for Substance Use Preve |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $408.24since 2024-04-01 | day | — | Plans negotiate; applies out of network | — | KY Medicaid Behavioral Health fee schedu |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $303.67since 2026-01-01 | day | — | Plans must pay at least this | — | Specialized Behavioral Health Services f |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $247.87since 2024-07-01 | day | — | Plans negotiate; applies out of network | — | OHP FFS behavioral health fee schedule ( |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $241.53since 2022-07-01 | day | — | Paid by the state, outside plans | — | MO HealthNet fee schedule: Comprehensive |
| OhioAgency provider · Ohio Medicaid (fee-for-service) | $240.95since 2024-01-01 | day | — | Plans expected to pay at least this | — | OAC 5160-27-03 Appendix A, Community Beh |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Public Behavioral Health System (specialty mental health, SUD and ABA, paid fee-for-service through the Carelon ASO) | $201.99since 2024-07-01 | day | — | Paid by the state, outside plans | — | FY2025 PBHS Fee Schedule – SUD_7.1.2024 |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $196.88since 2021-07-01 | day | — | Not classified | — | Health First Colorado Physician Fee Sche |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $86.92since 2025-01-01 | day | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Acquired Brain Injury (ABI I / ABI II) Waivers | $53.31since 2021-07-01 | day | — | Not classified | — | CMAP fee schedule: Acquired Brain Injury |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $14.20since 2024-01-01 | day | — | Plans negotiate; applies out of network | — | HCA Substance use disorder fee schedule |
Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.
Frequently asked questions
What does Medicaid pay for H2036?
It depends on the state. Of the 12 states with a published fee-for-service rate, the median is $241.24 per day. Massachusetts pays the most ($667.22 per day) and Washington the least ($14.20 per day).
Which state pays the highest Medicaid rate for H2036?
Massachusetts, at $667.22 per day, effective 2025-07-01.
Do managed-care plans pay the same rate for H2036?
Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The table shows the rule for each state, cited to the contract or statute.