Negotiated reimbursement rates vary substantially across all American Society of Addiction Medicine (ASAM) Levels of Care for facility-based services—even after standardizing codes and removing outliers, according to a recent analysis released by the National Association of Addiction Treatment Providers (NAATP).
The variation in reimbursement rates existed within and across payer networks, reflecting a fragmented and inequitable reimbursement environment rather than one driven by clinical outcomes, the report stated. The report outlines national commercial reimbursement patterns for Aetna, Blue Cross Blue Shield, Cigna, and United, including the Optum carrier networks.
The report is based on an analysis of in-network negotiated rates for more than 8,300 provider organizations publicly posted by these four major national commercial insurer networks through August 2025 as required by the federal Transparency in Coverage rule. NAATP partnered with subject matter experts from Third Horizon to create the report. Third Horizon specializes in analyzing, processing, and materializing behavioral health data posted by the health plans.
The report is organized by five ASAM Levels of Care, which represent the widely used clinical continuum of treatment framework that insurers contract providers with. The levels of care included are as follows:
- ASAM 2.1 Intensive Outpatient (IOP)
- ASAM 2.5 Partial Hospitalization (PHP)
- ASAM 3.5 Clinically Managed Residential Treatment
- ASAM 3.7 Medically Managed Residential Withdrawal Management
- ASAM 4.0 Hospital-Based Inpatient SUD Treatment
Higher-intensity levels of care showed wider variation in negotiated rates, according to a NAATP spokesperson. In several service categories, the most common negotiated rate differed meaningfully from the average rate, the spokesperson stated. As a result, provider organizations delivering comparable services may be operating under materially different reimbursement terms than peer providers in the market. The upper-bound negotiated rates were often much higher than the average rate. Residential and withdrawal management levels of care were particularly affected by this pattern.
The report findings are intended to support data-driven conversations among provider organizations, payers, and policymakers, the spokesperson stated. The report’s goal is to surface market dynamics that influence the sustainability of addiction treatment services and individual insurance members’ access to in-network care. The researchers observed and reported on carrier-level variation, but do not rank, score, or characterize individual carriers as consistently low or high paying, aggregated across levels of care.
NAATP’s Chief Executive Officer Marvin Ventrell said, “This report is fundamentally about sustainability and access. When reimbursement varies this widely, it directly affects whether providers can keep their doors open, retain qualified staff, and deliver the level of care patients actually need. Our goal is to bring clarity to a fragmented system so treatment remains available to the people who rely on it.”
“By organizing this data around ASAM Levels of Care, we reinforce that reimbursement should align with clinical intensity,” Mr. Ventrell continued. “Patients deserve access to the right level of care, and providers need reimbursement structures that make delivering that care viable. Over time, we plan to link negotiated payer rates to legitimate recovery and wellness outcomes, not just utilization metrics. This benchmark data can support better treatment through the development of meaningful value-based care for both payers and providers.”
NAATP is a non-profit professional society dedicated to ensuring the equitable availability and highest quality of addiction treatment. NAATP provides leadership, advocacy, training, research, and comprehensive member support. The Foundation for Recovery Science and Education is NAATP’s research and education arm that helps the field measure and demonstrate treatment effectiveness through standardized, de-identified outcomes data across levels of care.
The full text of the NAATP Addiction Treatment National Rate Benchmark Report was published on January 5, 2026. The full text is free for NAATP members; non-members can purchase a copy for $1,900 (accessed January 21, 2026).
For more information, contact: National Association of Addiction Treatment Providers, Post Office Box 271686, Louisville, Colorado 80027; 888-574-1008; Email: info@naatp.org; Website: https://www.naatp.org/
March 2026 00US26EUA0007