Cost of Services

Outpatient Sliding Fee Scale

Based on 2023 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 $14,580 $14,581 $18,225 $18,226 $21,870 $21,871 $25,515 $25,516 $51,032
2 $0 $19,720 $19,721 $24,651 $24,652 $36,978 $36,979 $64,714 $64,715 $129,430
3 $0 $24,860 $24,861 $31,076 $31,077 $46,616 $46,617 $81,580 $81,581 $163,161
4 $0 $30,000 $30,001 $37,501 $37,502 $56,253 $56,254 $98,445 $98,446 $196,892
5 $0 $35,140 $35,141 $43,926 $43,927 $65,891 $65,892 $115,311 $115,312 $230,624
6 $0 $40,280 $40,281 $50,351 $50,352 $75,528 $75,529 $132,176 $132,177 $264,355
7 $0 $45,420 $45,421 $56,776 $56,777 $85,166 $85,167 $149,042 $149,043 $298,086
8 $0 $50,560 $50,561 $63,201 $63,202 $94,803 $94,804 $165,908 $165,909 $331,817
% 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 $60.00
UA Code A phone $110.00 (per 10)
OR
UA Code A Phone $55.00 (per 5)
PBT 1x per day $3.00
PBT 2x per day - 24/7 style $5.00
UA 13 panel $11.00*
Cheek Swabs $11.00
K3 $45.00*
ETG $22.00*
Integrated Treatment Needs Assessment $50.00
Assessment with DSS funding $0.00
*Additional $22.00 lab fee




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)