Cost of Services

Outpatient Sliding Fee Scale

Based on 2024 Federal Poverty Guidelines
Family Size 100% Discount 80% Discount 60% Discount 40% Discount 20% Discount
Above Below Above Below Above Below Above Below Above Below
1 $0 $15,060 $15,061 $18,825 $18,826 $22,590 $22,591 $26,355 $26,356 $52,712
2 $0 $20,440 $20,441 $25,551 $25,552 $38,328 $38,329 $67,076 $67,077 $134,155
3 $0 $25,820 $25,821 $32,276 $32,277 $48,416 $48,417 $84,730 $84,731 $169,461
4 $0 $31,200 $31,201 $39,001 $39,002 $58,503 $58,504 $102,383 $102,384 $204,767
5 $0 $36,580 $36,581 $45,726 $45,727 $68,591 $68,592 $120,036 $120,037 $240,074
6 $0 $41,960 $41,961 $52,451 $52,452 $78,678 $78,679 $137,689 $137,690 $275,380
7 $0 $47,340 $47,341 $59,176 $59,177 $88,766 $88,767 $155,342 $155,343 $310,686
8 $0 $52,720 $52,721 $65,901 $65,902 $98,853 $98,854 $172,995 $172,996 $345,992
% of Poverty 100% 125% 150% 175% 200%
Plan Code 1 2 3 4 5
*For family units with more than 8 members, for each additional member add $5,140.



Outpatient/Aftercare/Day Reporting Services


TYPE OF SERVICE DESCRIPTION OF SERVICE UNIT COST
Sweat patch Every 10 days $61.00
UA Code A phone $120.00 (per 10)
OR
UA Code A Phone $60.00 (per 5)
UA 13 panel $12.00*
Cheek Swabs $12.00
K3 Send In $45.00*
ETG $23.00*
Integrated Treatment Needs Assessment $50.00
Assessment with DSS funding $0.00
*Additional $23.00 lab fee per drug
For confirmation, depending on the drug,
this fee will vary in cost.




GPS and SCRAM Services


TYPE OF SERVICE UNIT COST
SCRAM $9.00 per day*
GPS/Self pay $13.00 per day*
GPS/SCRAM $18.00 per day*
*Additional $35.00 activation fee.




Service Bundles


TYPE OF SERVICES UNIT COST
CAP/PBT-CAP stays same $1.00 off PBTs per day
CAP/GPS-CAP stays same $1.00 off GPS per day
CAP/SCRAM-CAP stays same $1.00 off SCRAM per day
Sweat Patch and GPS -Patch stays the same $1.00 off GPS per day
Sweat Patch and SCRAM- Patch stay the same $1.00 off SCRAM per day
Residential and Sweat Patch $50.00 (instead of $60.00)