See how many substance use IOP facilities reported accepting Medicaid, private health insurance, or both in SAMHSA's 2024 survey. Download the state counts.
In the 2024 SAMHSA public-use file, 4,517 of 6,921 included substance use IOP facility records (65.3%) reported accepting both Medicaid and private health insurance.
The analysis covers the 50 states and DC. An included record reports offering intensive outpatient treatment (IOP) for substance use and has yes or no answers for both payment types. The survey asks about payment for the facility's substance use treatment services as a whole. A referral still needs a check for the specific location, service and plan. Download the national and state counts.
Do IOP facilities accept Medicaid and private insurance?
Of the 6,921 included records, 5,339 reported accepting Medicaid (77.1%) and 5,716 reported accepting private health insurance (82.6%). The 4,517 records reporting both are included in both totals. The four groups below let you see the overlap without double counting.
| Reported payment types | Facility records | Share of included records |
|---|---|---|
| Medicaid and private health insurance | 4,517 | 65.3% |
| Medicaid without private health insurance | 822 | 11.9% |
| Private health insurance without Medicaid | 1,199 | 17.3% |
| Neither of those two payment types | 383 | 5.5% |
| Total | 6,921 | 100.0% |
For example, add 4,517 and 822 to get the Medicaid total. To find facilities reporting at least one of the two types, add the first three rows. That gives 6,538 records (94.5%). Some facilities may accept other forms of payment in any of the four groups, including the last group.
How did reported acceptance vary by state?
In Texas, 158 of 285 included records (55.4%) reported accepting both. New York had 160 records in the overlap, close to the Texas count, but a smaller denominator of 189. Its corresponding share was 84.7%. Comparing both the counts and percentages makes that difference visible.
| State | Included facility records | Reported accepting both | Share reporting both |
|---|---|---|---|
| California | 590 | 144 | 24.4% |
| Florida | 249 | 87 | 34.9% |
| New York | 189 | 160 | 84.7% |
| Texas | 285 | 158 | 55.4% |
The examples illustrate the range of results and how to read the denominator. The CSV includes all 50 states and DC. In a state with six included records, one facility changes the share by about 17 percentage points. Read small rows as counts from the survey. The table cannot explain differences between states, and it does not rank states by access to care.
If the question is whether an IOP facility also reports offering day treatment or partial hospitalization, use the companion analysis of outpatient service offerings. That analysis uses a different second question and denominator. Its state table can help frame a separate question about service availability.
What does accepting an insurance type tell you?
Question A17 of SAMHSA's 2024 questionnaire asks which “types of client payments or insurance” the facility accepts for substance use treatment services. It is separate from the question about which outpatient services the facility offers. A record can answer yes to both IOP and Medicaid while leaving unanswered whether the facility bills a particular Medicaid plan for IOP.
That distinction matters for admissions. A payer may list a practice or facility while the intake team still needs to check the site, billing provider and program the referral is for. The survey file does not identify the active benefits on a patient's policy, the authorization decision or what that patient will owe. For people with insurance, FindTreatment.gov suggests asking their insurer for “a list of preferred facilities or providers” in their area.
A referral coordinator can use a directory or a facility's description to identify whom to call. Then ask the facility which location offers the program, and ask the plan about that location and service for the relevant dates. Record who answered, what they confirmed and what still needs to be checked. Use a current benefits response to inform a referral, and follow up on details the response leaves open.
For a program planning its admissions workload, use the state counts to decide which payment questions to include in the intake script. Use the program's own referrals to estimate how often staff will actually run each check. The survey gives each facility one count, so the share of facility records accepting Medicaid cannot tell you the share of referrals that arrive with Medicaid.
For example, a director could review a fictional batch of 20 referrals before testing an intake system. Record the reported insurance type for each referral, then count how many still need someone to confirm the program at the receiving location. If several referrals share the same unresolved question, use that pattern to test whether the system shows the owner and next step clearly. The useful number for staffing is the number of open checks in the program's own queue. The survey table provides a separate view of what facilities reported accepting.
How can an intake team test that distinction?
Use a fictional referral for a person whose plan is listed in the directory and whose recommended program is IOP. The sample facility reports accepting Medicaid at the organization level. The plan response shows active coverage but leaves the IOP benefit at the receiving location unanswered. Ask intake to show exactly where the open question lives and how it reaches the next person.
| Step | What to record | What the next person can check |
|---|---|---|
| Identify the service | Receiving location, IOP and planned start date | The referral names the location and program being checked |
| Review eligibility | Plan, date of service, source and date of the response | The response applies to the plan and dates on the referral |
| Ask about the missing benefit | Specific question, named owner and due date | The next person sees which answer is still open |
| Record the follow-up | The response from the plan and any authorization question | Intake and billing can see the evidence and any remaining follow-up |
Repeat the exercise with a private plan and the same fictional program. Keep the directory listing the same. Change only the response about the program at the receiving location. Compare how clearly the team can distinguish an active policy from a verified benefit, and whether the second check preserves the first one for review.
Use the eligibility, benefits and authorization guide to prepare the intake questions and the IOP EHR buyer guide to evaluate the scheduling, documentation and billing handoff together.
How were the results calculated?
Start with the Delimited archive and codebook on the 2024 N-SUMHSS data files page. The 2024 codebook labels these two variables “Accepts Medicaid payments” and “Accepts private health insurance.”
- Keep the 50 states and DC in
LOCATIONSTATE. Keep records withCTYPE1andCTYPE2equal to 1, indicating outpatient substance use treatment and intensive outpatient treatment. - Check
REVCHK5_SUfor Medicaid andREVCHK2_SUfor private health insurance. A 1 means yes and a 0 means no. Include the record only if both values are 0 or 1. - Count the yes/yes, yes/no, no/yes and no/no combinations by state. Sum the state and DC counts for the national row. Divide each count by the number of included records and round to one decimal place.
Of the 6,931 records reporting IOP in the included geography, ten lacked valid answers for the two payment items and were excluded. Each included record contributes one count. A large facility and a small facility contribute equally. The results measure facility responses in 2024, so use separate data for the number of patients served, appointment availability, payment amounts or present-day participation.
How should you cite or reuse the figures?
Include the year, the geography and the denominator with any percentage. For the national overlap, cite the Ease Health analysis of the 2024 SAMHSA N-SUMHSS public-use file and specify that 4,517 of 6,921 substance use IOP facility records with valid answers to both payment items reported both. If quoting the Texas share, use 158 of 285 and specify that the result applies to the same 2024 survey and filters.
The geography column in the downloadable table uses postal abbreviations. The four answer columns add up to the denominator in every row. To compare future years, repeat the calculation on the corresponding public-use file with the same geography and question definitions, and report any changes in who was included.
Keep a copy of the Delimited archive and its codebook with any analysis you reuse, so a second reader can reproduce the result from the same release.
Frequently Asked Questions
How many substance use IOP facilities reported accepting Medicaid?
Of 6,921 facility records reporting substance use IOP and with valid answers to both payment questions, 5,339 (77.1%) reported accepting Medicaid. The 2024 SAMHSA public-use calculation covers the 50 states and DC.
How many reported accepting private health insurance?
Of 6,921 included substance use IOP facility records, 5,716 (82.6%) reported accepting private health insurance. That includes the 4,517 records that also reported accepting Medicaid.
Does accepting Medicaid mean the facility covers IOP for a patient?
The payment question asks about the facility's substance use treatment services as a whole. For an individual referral, confirm the specific plan, location, service and any authorization requirements with the facility and the plan.
What does neither mean in the table?
The facility record has a no response for both Medicaid and private health insurance. Other payment options were outside this calculation.
