Medicaid providers in Houston submitted $216,421,301 in claims for services classified within the Alcohol and Drug Abuse Treatment category in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. That figure reflects a 6.2% increase over 2023, when such claims totaled $203,864,480.
Medicaid is a public insurance program operated by the states and supported through both federal and state funding. The program provides coverage for low-income families and individuals, seniors, children and those with disabilities, making it one of the largest health care payers in the United States.
Because taxpayer funding supports Medicaid payments, significant changes in billing can reveal how publicly funded health care dollars are deployed locally.
The “Alcohol and Drug Abuse Treatment” group covers specific Medicaid-billed services based on the care provided, using standardized HCPCS and CPT code groupings. For this analysis, billing codes were assigned to one service category according to consistent code prefixes and numerical ranges, allowing these related services to be compared over time, without double counting or impacting rankings.
While Medicaid payments increased across several service groups, Alcohol and Drug Abuse Treatment was ranked third for total spending in Houston in 2024.
Statewide in Texas, Alcohol and Drug Abuse Treatment placed fourth in total Medicaid payments in 2024.
Over the five years before 2024, Medicaid outlays for Alcohol and Drug Abuse Treatment services in Houston rose by $201,858,029, amounting to a 1386.1% increase. Some of the highest year-over-year jumps were reported in 2020 and 2021.
Although spending on Alcohol and Drug Abuse Treatment was distributed throughout the city, payments were most concentrated in a few ZIP codes. In 2024, ZIP code 77074 received $28,418,791, 77060 saw $26,062,538, and 77083 recorded $19,814,307. These top 3 ZIP codes made up 34.3% of all Medicaid spending in this service area across Houston during the year.
Within Alcohol and Drug Abuse Treatment, most Medicaid payments were focused on a relatively small group of individual billing codes.
To compare growth rates, Medicaid outlays linked to Alcohol and Drug Abuse Treatment in Houston went up 6.2% from 2023 to 2024, while payments in all Medicaid claim groups citywide rose by 9.1% during that period.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid spending together totaled approximately $871.7 billion in fiscal 2023, which represented nearly 18% of national health expenditures—up from about $613.5 billion in 2019, prior to the COVID-19 pandemic.
This amounts to about 40% spending growth over just a few years, fueled chiefly by increased enrollment and higher utilization during and after the pandemic.
Recent budget legislation signed in the Trump administration has included major proposals that seek to shrink federal Medicaid funding and change the program’s structure. The “One Big Beautiful Bill Act,” approved in 2025, is projected to reduce federal Medicaid spending by more than $1 trillion over 10 years and implements measures such as work requirements and increased cost-sharing, which could limit Medicaid coverage and funding for some. Such policy changes may increase cost burdens for states and slow future federal Medicaid growth, even as the program continues to cover tens of millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $14,563,272 | 202.7% |
| 2021 | $53,724,740 | 268.9% |
| 2022 | $142,307,693 | 164.9% |
| 2023 | $203,864,480 | 43.3% |
| 2024 | $216,421,301 | 6.2% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Temporary National Codes (Non-Medicare) | $501,668,290 | 30.1% |
| 2 | National Codes Established for State Medicaid Agencies | $383,673,806 | 23% |
| 3 | Alcohol and Drug Abuse Treatment | $216,421,301 | 13% |
| 4 | Evaluation and Management | $206,888,444 | 12.4% |
| 5 | Medicine Services and Procedures | $119,311,256 | 7.2% |
| 6 | Pathology and Laboratory Procedures | $52,368,533 | 3.1% |
| 7 | Enteral and Parenteral Therapy | $44,407,383 | 2.7% |
| 8 | Dental Services | $33,954,909 | 2% |
| 9 | Ambulance and Other Transport Services and Supplies | $20,159,837 | 1.2% |
| 10 | Durable Medical Equipment | $16,571,528 | 1% |
| 11 | Radiology Procedures | $15,846,560 | 1% |
| 12 | Medical And Surgical Supplies | $15,158,355 | 0.9% |
| 13 | Surgery | $14,399,464 | 0.9% |
| 14 | Procedures / Professional Services | $10,898,526 | 0.7% |
| 15 | Anesthesia | $5,987,780 | 0.4% |
| 16 | Vision Services | $2,687,763 | 0.2% |
| 17 | Drugs Administered Other than Oral Method | $1,372,135 | 0.1% |
| 18 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $1,355,455 | 0.1% |
| 19 | Miscellaneous Medical Services | $1,027,621 | 0.1% |
| 20 | Chemotherapy Drugs | $394,113 | <0.1% |
| 21 | Administrative, Miscellaneous and Investigational | $232,070 | <0.1% |
| 22 | Orthotic Procedures and services | $174,786 | <0.1% |
| 23 | Pathology and Laboratory Services | $104,062 | <0.1% |
| 24 | Temporary Codes | $26,446 | <0.1% |
| 25 | Coronavirus Diagnostic Panel | $24,668 | <0.1% |
| 26 | Hearing Services | $5,417 | <0.1% |
| 27 | Prosthetic Procedures | $2,076 | <0.1% |
| 28 | Other Services | $0 | <0.1% |
| 28 | Outpatient PPS | $0 | <0.1% |
| 28 | Screening Procedures | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| H2016 | Comp comm supp svc, per diem | $103,511,999 | 778 |
| H2014 | Skills train and dev, 15 min | $94,908,573 | 1,481 |
| H2017 | Psysoc rehab svc, per 15 min | $9,139,402 | 129 |
| H2032 | Activity therapy, per 15 min | $2,565,892 | 56 |
| H2035 | A/d tx program, per hour | $1,478,369 | 20 |
| H2019 | Ther behav svc, per 15 min | $1,262,259 | 144 |
| H2015 | Comp comm supp svc, 15 min | $937,776 | 33 |
| H2011 | Crisis interven svc, 15 min | $758,946 | 26 |
| H0034 | Med trng & support per 15min | $469,128 | 151 |
| H2036 | A/d tx program, per diem | $347,900 | 4 |
| H0020 | Alcohol and/or drug services | $283,969 | 39 |
| H2012 | Behav hlth day treat, per hr | $235,976 | 12 |
| H2038 | Skill train and dev/diem | $136,073 | 11 |
| H0004 | Alcohol and/or drug services | $135,885 | 40 |
| H2013 | Psych hlth fac svc, per diem | $99,217 | 10 |
| H0035 | Mh partial hosp tx under 24h | $51,542 | 2 |
| H0036 | Comm psy face-face per 15min | $47,318 | 5 |
| H0049 | Alcohol/drug screening | $21,452 | 129 |
| H0005 | Alcohol and/or drug services | $15,145 | 6 |
| H0038 | Self-help/peer svc per 15min | $7,186 | 10 |
Note: HCPCS codes are shown for context within the category. Category totals and rankings in this article are based on standardized service groupings rather than individual billing codes.
Information in this article was obtained from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The source data can be found here.
