HCPCS H0020: Methadone Administration by Licensed Program
HCPCS Level II code H0020 describes methadone administration and related services provided by a licensed substance use disorder treatment program; the service represents on-site provision of the medication and associated clinical oversight for patients with opioid use disorder and is typically delivered as medication-assisted treatment (MAT) in outpatient clinic or opioid treatment program settings.
For related coverage guidance, see recent payer policy updates: Home Health, Skilled, and Custodial Care Services (for Idaho Only), Private Duty Nursing Services, Private Duty Nursing Services (for Florida Only).
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National Reimbursement Benchmarks
National commercial rates for HCPCS H0020 cluster around BUCA’s average commercial benchmark of $61.20, with substantial variation by payer. UnitedHealth Group shows the highest central tendency with a median of $248.80 and a mean of $259.40, while Blue Cross Blue Shield centers much lower with a median of $15.90 and a mean of $21.70. Cigna and Aetna have similar central tendencies in the low $20s mean but different medians: Cigna median $12.20 and Aetna median $19.00. BUCA’s median of $54.60 sits between these groups as an average commercial reference point.
Dispersion measured by the interquartile range (P75–P25) highlights concentration differences: Blue Cross Blue Shield’s IQR is $6.40 (from $12.50 to $31.90), indicating one of the tighter distributions, while UnitedHealth Group’s IQR is $24.90 (from $236.30 to $261.20), the widest among listed payers. Cigna’s IQR is $5.80 and Aetna’s is $0.20, with Aetna being the tightest; BUCA’s IQR is $10.90 (from $50.80 to $65.70), showing moderate dispersion around its $61.20 mean.