Rehab Cost in Texas: 2026 Treatment Cost Guide
Texas faces a growing addiction crisis driven by fentanyl, methamphetamine, and prescription opioids. In 2023, the state recorded 5,687 drug overdose deaths — a rate of 19.0 per 100,000 residents. While this rate falls below the national average of 32.4, the sheer volume makes Texas one of the hardest-hit states by total deaths. Fentanyl and other synthetic opioids were involved in 46% of these fatalities, according to the Texas Department of State Health Services.
Compounding the treatment challenge, Texas has the highest uninsured rate in the nation at 16.7% (U.S. Census Bureau, 2024) — more than double the national average — and has not expanded Medicaid. This means millions of Texans face significant barriers to accessing affordable addiction treatment. This guide breaks down exactly what treatment costs in Texas, what insurance covers, and how to access care regardless of your financial situation.
Rehab Costs in Texas: 2026 Overview
| Treatment Type | Without Insurance | With PPO Insurance | Duration |
|---|---|---|---|
| Medical Detox | $2,000 – $10,000 | $800 – $4,000 | 5-14 days |
| Inpatient Rehab (Basic) | $15,000 – $25,000 | $6,000 – $12,000 | 30 days |
| Inpatient Rehab (Mid-Tier) | $25,000 – $40,000 | $10,000 – $18,000 | 30 days |
| Luxury/Executive Programs | $40,000 – $100,000+ | $15,000 – $35,000 | 30 days |
| Partial Hospitalization (PHP) | $4,000 – $14,000 | $1,500 – $6,000 | per month |
| Intensive Outpatient (IOP) | $3,000 – $10,000 | $1,200 – $4,000 | per month |
| Standard Outpatient | $1,500 – $5,000 | $400 – $2,000 | per month |
| Medication-Assisted Treatment | $200 – $800/month | $25 – $200/month | ongoing |
| Sober Living (Texas) | $500 – $3,000/month | typically not covered | ongoing |
Source: National Center on Addiction and Substance Abuse; Texas facility-reported data aggregated by ClearCostRecovery, 2026.
Texas treatment costs are generally lower than coastal states like California, New York, and Florida. The state ranks 18th nationally for residential rehab costs and 2nd most affordable in the Southwest region. Major metro areas (Houston, Dallas) command higher prices, while programs in Central, West, and South Texas offer more budget-friendly options.
Texas Addiction Treatment Landscape
Texas operates one of the largest addiction treatment systems in the country with approximately 550 licensed treatment facilities serving nearly 36,000 individuals annually. The state’s vast geographic footprint creates significant regional variation in treatment availability and cost.
Distribution of Treatment Facilities by Region
Texas treatment infrastructure concentrates in major metropolitan areas, with rural communities facing severe access gaps:
Houston Metro (Harris, Fort Bend, Montgomery, Galveston): Largest treatment market in Texas with approximately 140 facilities. Mix of luxury private centers, hospital-based programs, and community providers. Costs tend to be highest in this region, with luxury programs ranging $40,000-$100,000+.
Dallas-Fort Worth Metroplex (Dallas, Tarrant, Collin, Denton): Approximately 120 facilities serving the state’s second-largest metro area. Strong mid-tier market with multiple national treatment chains. Competitive pricing due to market density.
Austin-San Antonio Corridor (Travis, Bexar, Williamson, Hays): Approximately 95 facilities. Growing market with innovative treatment approaches. Austin’s tech-forward culture has attracted modern treatment modalities and telehealth-forward programs.
Rio Grande Valley/South Texas (Hidalgo, Cameron, Webb): Limited treatment infrastructure with approximately 35 facilities serving a large, predominantly uninsured population. Significant access barriers including language, transportation, and insurance coverage.
West Texas/Panhandle (El Paso, Lubbock, Amarillo): Sparse treatment options with approximately 25 facilities across a massive geographic area. Residents often travel 200+ miles for residential care.
East Texas (Tyler, Longview, Beaumont): Approximately 40 facilities. Strong faith-based treatment tradition with multiple Teen Challenge and Salvation Army programs.
Rural Texas counties — particularly in the Panhandle, West Texas, and the border region — have minimal treatment infrastructure. Telehealth has expanded access somewhat, but residential care requires travel to metro areas for most rural Texans.
Key Texas Treatment Regulations
Texas Health and Human Services Commission (HHSC) Licensing: All Texas substance use disorder treatment programs must be licensed by HHSC. Requirements include:
- Qualified credentialed counselor (QCC) or licensed chemical dependency counselor (LCDC) staffing
- Medical director for detox and residential programs
- Comprehensive biopsychosocial assessment at admission
- Individualized treatment planning with client participation
- Discharge planning and aftercare coordination
- Fire safety and facility standards compliance
Patient Protection Measures: Texas law prohibits patient brokering (paying for referrals) and requires facilities to provide written cost estimates before admission. The HHSC conducts regular inspections and investigates complaints.
OSAR System: Texas operates an Outreach, Screening, Assessment and Referral (OSAR) system through its 11 HHSC regions. OSAR serves as the gateway to publicly-funded treatment, connecting uninsured and underinsured individuals with appropriate care at no cost or reduced fees.
Mental Health Parity Enforcement: Texas Department of Insurance enforces federal parity laws requiring insurers to cover addiction treatment at the same level as medical/surgical care.
Insurance Coverage in Texas
Texas has the highest uninsured rate in the nation at 16.7% (U.S. Census Bureau, 2024), driven primarily by the state’s decision not to expand Medicaid. Approximately 21.6% of adults ages 19-64 and 13.6% of children lack health insurance — both roughly double the national rates.
Major Insurance Carriers in Texas
Blue Cross Blue Shield of Texas (BCBSTX) — Largest carrier in the state with 6+ million members. Extensive network covering most licensed treatment facilities. Generally strong coverage for residential treatment with pre-authorization.
UnitedHealthcare — Major presence through employer plans and Medicare Advantage. Optum manages behavioral health benefits. Typically requires step-down to outpatient after initial inpatient authorization.
Aetna — Strong PPO coverage with national network access. Covers residential treatment at 70-80% after deductible for most plans.
Cigna — Significant Texas market share through employer plans. Evernorth behavioral health manages addiction benefits with good MAT coverage.
Humana — Large Medicare Advantage presence. Covers addiction treatment for qualifying beneficiaries with growing network of treatment providers.
Ambetter/Superior Health Plan — Major Healthcare.gov marketplace carrier in Texas. Essential health benefit coverage includes substance abuse treatment, though networks are more limited than legacy carriers.
Molina Healthcare — Marketplace and Medicaid managed care presence. Growing Texas enrollment with addiction treatment coverage.
What Insurance Covers in Texas
Under federal law and the ACA, your Texas health insurance must cover:
- Inpatient/residential treatment (ASAM Levels 3.1-3.7)
- Medical detoxification
- Partial hospitalization (ASAM Level 2.5)
- Intensive outpatient (ASAM Level 2.1)
- Standard outpatient therapy
- Medication-assisted treatment (Suboxone, methadone, naltrexone, Antabuse)
- Psychiatric care for co-occurring disorders
- Family therapy and counseling
- Case management and peer support
Mental Health Parity laws require that addiction treatment benefits match medical/surgical benefits in cost-sharing, visit limits, and authorization requirements. Insurance typically covers 50-100% of treatment costs depending on plan type and network status.
Texas Medicaid Coverage Gap
Texas’s decision not to expand Medicaid under the ACA created the largest coverage gap in the nation, affecting approximately 1.4 million low-income adults.
Who Qualifies for Texas Medicaid:
- Pregnant women (up to 198% FPL)
- Children under 19 (CHIP up to 201% FPL)
- Parents with dependent children (extremely low income limits — approximately $230/month for a family of three)
- Elderly (65+)
- Disabled individuals (SSI recipients)
Who Does NOT Qualify:
- Childless adults under 65, regardless of income
- Parents earning above the extremely low threshold
- Most low-income adults without children or disabilities
For Those in the Coverage Gap:
- Healthcare.gov marketplace with subsidies (if income 100-400% FPL)
- State-funded treatment through OSAR system
- Federally Qualified Health Centers (sliding scale)
- Faith-based free programs (Salvation Army, Teen Challenge)
- Facility charity care and scholarships
- County indigent healthcare programs
Free and Low-Cost Treatment Options in Texas
State-Funded Programs Through OSAR
Texas Health and Human Services Commission operates the Outreach, Screening, Assessment and Referral (OSAR) system across 11 regions, providing the gateway to publicly-funded substance use disorder treatment. OSAR services include:
- Free screening and assessment
- Referral to appropriate level of care
- Access to state-funded outpatient and residential programs
- Medication-assisted treatment
- Case management and peer support
How to Access: Call the statewide OSAR line at 1-877-541-7905 or contact your regional OSAR office directly. You can also dial 2-1-1 or text your zip code to 898211 to be connected with a specialist.
Each of the 11 HHSC regions has designated OSAR providers embedded in Local Mental Health Authorities (LMHAs) and Local Behavioral Health Authorities (LBHAs), ensuring statewide coverage even in rural areas.
Faith-Based Free Programs
Salvation Army Adult Rehabilitation Centers — Free 6-12 month residential programs in Houston, Dallas, San Antonio, Austin, Fort Worth, El Paso, Corpus Christi, and other cities. Participants work in Salvation Army retail stores as part of vocational therapy.
Teen Challenge Texas — Faith-based long-term residential care (12-15 months) for ages 18+ at minimal cost ($200-$500/month donation requested but not required). Multiple locations across Texas including Houston, San Antonio, and Midland.
Cenikor Foundation — Nonprofit providing free long-term residential treatment (6-12 months) at locations in Houston, Fort Worth, Baton Rouge, and Denver. Work-based model with vocational training.
Victory Outreach — Faith-based recovery homes in multiple Texas cities offering free long-term residential programs.
Community Health Centers
Texas has 72 Federally Qualified Health Centers (FQHCs) — the most of any state — offering addiction services on sliding fee scales (0-100% of cost based on income):
- Legacy Community Health (Houston) — Multiple locations, comprehensive addiction services
- Community Health Development (Uvalde area, South Texas)
- El Centro de Corazón (Houston)
- Lone Star Community Health Center (Conroe)
- People’s Community Clinic (Austin)
- CommuniCare Health Centers (San Antonio)
Detox Costs in Texas
Medical detoxification costs in Texas are generally lower than coastal states:
Alcohol Detox: $300-$800 per day ($2,100-$11,200 for 7-14 days). Alcohol withdrawal requires intensive 24/7 medical monitoring for seizure risk, vital sign instability, and delirium tremens complications. Texas has strong capacity for alcohol detox across metro areas.
Opioid Detox: $250-$700 per day ($1,750-$7,000 for 7-10 days). Most Texas programs use buprenorphine-assisted withdrawal protocols. Many programs transition patients to ongoing Suboxone or Vivitrol maintenance.
Benzodiazepine Detox: $300-$800 per day ($4,200-$11,200 for 14+ days). Benzodiazepine withdrawal requires slow taper protocols and prolonged monitoring due to seizure risk.
Stimulant Detox (Methamphetamine/Cocaine): $200-$500 per day ($1,000-$3,500 for 5-7 days). Medically safer than alcohol or benzo withdrawal but requires psychiatric monitoring for depression and suicidal ideation. Methamphetamine use has surged significantly in Texas.
Fentanyl Detox: $300-$800 per day ($3,000-$8,000 for 10+ days). Fentanyl’s high potency and variable half-life complicate withdrawal. Extended buprenorphine induction protocols (micro-dosing) are increasingly common in Texas facilities.
Most insurance covers medical detox at 80-100% under medical benefits with deductible and coinsurance applying.
Medication-Assisted Treatment (MAT) Costs in Texas
Texas has expanded MAT access significantly in recent years:
Suboxone/Buprenorphine:
- Without insurance: $350-$750/month
- With insurance: $25-$200/month
- Texas has 3,500+ licensed buprenorphine prescribers, concentrated in metro areas
Methadone:
- Without insurance: $250-$500/month
- With insurance: $50-$200/month
- Texas has 90+ licensed opioid treatment programs (OTPs)
Naltrexone/Vivitrol:
- Oral naltrexone: $50-$150/month without insurance, $10-$50 with insurance
- Vivitrol injection: $1,300-$1,700/month without insurance, $0-$300 with insurance
Disulfiram (Antabuse):
- $40-$100/month without insurance, $10-$30 with insurance
Rural access to MAT remains a significant challenge. Telehealth prescribing of buprenorphine has expanded access, with Texas Medicaid now covering behavioral telehealth as one of its most utilized services.
Choosing the Right Rehab in Texas
With over 550 facilities, selecting the right program requires careful evaluation:
Verify HHSC Licensure: Check facility license status through the Texas Health and Human Services Commission facility search tool.
Accreditation: Look for Joint Commission, CARF, or COA accreditation beyond state licensing. Accredited facilities meet higher standards for patient care and safety.
Evidence-Based Practices: Quality programs offer cognitive-behavioral therapy (CBT), motivational interviewing, trauma-informed care, and medication-assisted treatment when clinically appropriate.
Cultural Competency: Texas’s diverse population (40% Hispanic/Latino) makes bilingual services and culturally competent care important considerations, particularly in South Texas and border communities.
Insurance Verification: Request written benefits verification before admission showing exactly what your plan covers, including deductible status, coinsurance, and out-of-pocket maximum.
Beware of Predatory Practices: Warning signs include unsolicited phone calls offering free treatment, promises of guaranteed results, pressure to admit immediately, or refusal to provide written cost estimates.
Texas Addiction Crisis by the Numbers
Overdose Trends:
- 2019: 3,387 deaths (pre-fentanyl baseline)
- 2021: 5,012 deaths (COVID-era surge)
- 2023: 5,687 deaths (record high, fentanyl at 46%)
- 2024: Preliminary data shows 12% decline from 2023 peak
Drug poisoning became the leading cause of injury-related death for Texans aged 24-69 in 2023. Males have drug poisoning death rates over twice as high as females.
Geographic Impact: Texas’s overdose crisis is concentrated in urban areas, but rural communities face rapidly rising rates. The I-35 corridor (Dallas-Austin-San Antonio) and the Gulf Coast (Houston-Beaumont) report the highest absolute death counts. Border communities face unique challenges with illicit fentanyl trafficking.
Substances of Concern:
- Fentanyl/synthetic opioids: 46% of overdose deaths
- Methamphetamine: Rising sharply, particularly in rural areas
- Cocaine: Significant presence, often mixed with fentanyl
- Prescription opioids: Declining but still substantial
- Alcohol: Remains the most common substance use disorder statewide
Texas Addiction Resources
Crisis Hotlines:
- Texas OSAR (Treatment Access): 1-877-541-7905
- Texas 2-1-1 (Mental Health & Substance Use Referral): 2-1-1
- SAMHSA National Helpline: 1-800-662-4357
- 988 Suicide & Crisis Lifeline: 988
- Crisis Text Line: Text HOME to 741741
State Agencies:
- TX Health and Human Services, Substance Use: hhs.texas.gov/services/mental-health-substance-use
- TX Dept of State Health Services: dshs.texas.gov
- Healthcare.gov Texas: healthcare.gov
Recovery Support:
- AA Texas: Multiple intergroups with 5,000+ meetings statewide
- NA Texas: Regional service committees across the state
- SMART Recovery: Multiple Texas locations
- Celebrate Recovery: Widespread church-based programs
Sources
- Texas Department of State Health Services, Overdose Data to Action, 2023.
- CDC WONDER, National Vital Statistics, 2023.
- SAMHSA Treatment Locator, Texas, 2026.
- U.S. Census Bureau, American Community Survey, 2024.
- National Center on Addiction and Substance Abuse, 2025.
- Texas Health and Human Services Commission, Substance Use Disorder Services, 2024.
- Dallas Federal Reserve, Southwest Economy: Opioid Crisis Analysis, 2025.
You May Qualify for Coverage That Pays for treatment in Texas
Under the Affordable Care Act, all marketplace health insurance plans must cover addiction treatment as an essential health benefit. Monthly premiums for a PPO plan that covers rehab typically range from $350 to $700 — a fraction of the cost of paying out of pocket.
A licensed insurance specialist can help you find the right plan, check for qualifying life events, and get covered — often within days.
Talk to an Insurance Specialist — Free & ConfidentialTexas Crisis Resources
Texas OSAR (Outreach, Screening, Assessment & Referral): 1-877-541-7905
Texas Health and Human Services Commission, Substance Use Disorder Services: https://www.hhs.texas.gov/services/mental-health-substance-use
SAMHSA National Helpline: 1-800-662-4357
Frequently Asked Questions
How much does rehab cost in Texas?
Rehab in Texas costs between $15,000 and $60,000 for a 30-day inpatient program without insurance. With PPO insurance, out-of-pocket costs typically range from $6,000 to $20,000. Texas ranks as one of the more affordable states for addiction treatment — 18th nationally for residential care costs — due to lower operating costs and a competitive market with over 550 licensed facilities. Houston luxury programs run $30,000-$100,000+, while basic residential programs in Central and West Texas start around $15,000-$25,000.
How much does a full rehab program cost in Texas?
A complete treatment episode in Texas including all phases costs $20,000-$75,000 without insurance. This typically includes medical detox ($2,000-$10,000 for 5-14 days), inpatient rehab ($15,000-$60,000 for 30 days), intensive outpatient ($3,000-$10,000 for 8-12 weeks), and standard outpatient therapy ($1,500-$5,000 for 3-6 months). With insurance covering 50-100% of costs, out-of-pocket expenses range from $5,000-$20,000 for the complete continuum of care.
Does insurance cover drug rehab in Texas?
Yes. All health insurance plans sold in Texas — including employer plans, ACA marketplace plans, and Medicare — must cover substance use disorder treatment as an essential health benefit under the Affordable Care Act. The Mental Health Parity and Addiction Equity Act requires insurers to cover addiction treatment at the same level as other medical conditions. Insurance typically covers 50-100% of rehab costs, reducing out-of-pocket expenses significantly. However, Texas has the highest uninsured rate in the nation at 16.7%, meaning millions of Texans lack this coverage.
Does Texas Medicaid cover drug rehab?
Texas Medicaid covers drug rehab for eligible beneficiaries, but Texas has not expanded Medicaid under the ACA, making eligibility extremely restrictive. Only pregnant women, children, parents with very low incomes (about $230/month for a family of three), elderly, and disabled individuals qualify. Childless adults generally do not qualify regardless of income. For those who do qualify, Texas Medicaid covers outpatient counseling, medication-assisted treatment, and some residential care. Low-income adults who don't qualify must seek county-funded programs, sliding-scale facilities, or marketplace insurance with subsidies.
How much is inpatient rehab in Texas?
Inpatient rehab in Texas ranges from $15,000 to $60,000 for 30 days without insurance. Basic residential programs in smaller cities and rural areas cost $15,000-$25,000. Mid-tier programs in Dallas, Austin, San Antonio, and Fort Worth run $25,000-$40,000. Luxury and executive programs in Houston and Dallas charge $40,000-$100,000+. With insurance, out-of-pocket costs depend on your deductible and coinsurance, typically $6,000-$20,000 for 30 days. Texas ranks 2nd most affordable in the Southwest region for residential care.
Are there free rehabs in Texas?
Yes, Texas has multiple free and low-cost rehab options. State-funded programs through Texas HHSC's Outreach, Screening, Assessment and Referral (OSAR) system provide free or sliding-scale treatment across all 11 HHSC regions. Salvation Army Adult Rehabilitation Centers offer free 6-12 month residential programs in Houston, Dallas, San Antonio, Austin, Fort Worth, and other cities. Teen Challenge Texas provides faith-based long-term residential care at minimal cost. Additionally, 194 Texas programs offer payment assistance and 201 offer sliding-scale fees for low-income individuals.
How long is inpatient rehab in Texas?
Most people in Texas inpatient rehab stay for 30 days, which is the standard program length covered by most insurance plans. However, clinical research shows that 60-90 day programs produce significantly better long-term outcomes. Texas offers short-term detox (5-14 days), 30-day residential (most common), 60-day extended care, 90-day long-term residential, and 6-12 month therapeutic communities. Insurance typically authorizes 30 days initially with continued stay reviews every 7-14 days for possible extensions based on medical necessity.
How much does outpatient rehab cost in Texas?
Outpatient rehab in Texas averages $1,640 for a 30-day program without insurance, or about $54 per day. Intensive outpatient programs (IOP) run $3,000-$10,000 for a standard 8-12 week course. Standard outpatient therapy costs $1,500-$5,000 per month. With insurance, out-of-pocket costs drop to $400-$2,000 per month for standard outpatient and $1,200-$4,000 for IOP. Texas ranks 7th nationally for outpatient affordability and 2nd most affordable in the Southwest region.
How do I pay for rehab in Texas without insurance?
Texas offers several options for people without insurance. State-funded programs through HHSC provide free or sliding-scale treatment — contact the OSAR system at 1-877-541-7905. Federally Qualified Health Centers offer addiction services on sliding fee scales based on income. Faith-based programs like Salvation Army and Teen Challenge provide free residential treatment. Many private facilities offer payment plans, scholarships, and charity care. You may also qualify for ACA marketplace insurance with premium subsidies through Healthcare.gov, which covers addiction treatment as an essential health benefit.
What is the cheapest rehab in Texas?
The most affordable rehab options in Texas are free through faith-based programs like Salvation Army Adult Rehabilitation Centers (6-12 month residential in exchange for work therapy) and Teen Challenge (12-15 month faith-based residential). State-funded programs through OSAR provide sliding-scale services starting at $0 based on income. Federally Qualified Health Centers offer free outpatient addiction services for uninsured individuals. For those with marketplace insurance, subsidized plans cover treatment with copays of $50-$300 per session. Some Texas facilities offer scholarships reducing costs to $5,000-$10,000 for 30-day programs.
How much does alcohol rehab cost in Texas?
Alcohol rehab in Texas costs $15,000-$60,000 for 30 days of inpatient treatment without insurance. Alcohol detox adds $2,000-$10,000 (5-14 days) due to medical complexity and seizure risk requiring 24/7 physician oversight. With insurance, out-of-pocket costs are typically $6,000-$20,000 for inpatient including detox. Outpatient alcohol programs cost $1,500-$5,000 per month without insurance, or $400-$2,000/month with insurance. Many Texas programs offer medication-assisted treatment for alcohol use disorder (naltrexone, Antabuse, Campral) covered by most insurance plans.
Does Blue Cross Blue Shield cover rehab in Texas?
Yes, Blue Cross Blue Shield of Texas (BCBSTX) covers addiction treatment including inpatient rehab, outpatient counseling, medical detox, and medication-assisted treatment. BCBSTX is one of the largest carriers in the state with extensive provider networks. Coverage specifics vary by plan type — PPO plans offer more flexibility in choosing facilities, while HMO plans require in-network providers. Under the Mental Health Parity Act, BCBSTX must cover addiction treatment at the same level as medical/surgical benefits. Contact your plan directly for pre-authorization requirements and specific benefit details.
How much does detox cost in Texas?
Medical detox in Texas costs $200-$800 per day depending on substance and complexity. Alcohol detox runs $300-$800/day ($2,100-$11,200 for 7-14 days) due to seizure risk. Opioid detox costs $250-$700/day ($1,750-$7,000 for 7-10 days). Benzodiazepine detox is $300-$800/day ($4,200-$11,200+ for 14+ days). Stimulant detox costs $200-$500/day ($1,000-$3,500 for 5-7 days). Most insurance covers medical detox at 80-100% under medical benefits. State-funded detox is available through OSAR for uninsured individuals.
What are the best rehab centers in Texas?
Texas has numerous highly-rated treatment programs rather than a single 'best' facility. Top-rated programs include: Greenhouse Treatment Center (Dallas area, all substances), La Hacienda Treatment Center (Hill Country, established 1972), Right Step (multiple Texas locations), Stonegate Center (Azle, near Fort Worth), and Origins Recovery Center (South Padre Island). The best program depends on your specific needs: addiction type, co-occurring disorders, insurance coverage, location preference, and treatment philosophy. Always verify DCF licensing and look for Joint Commission, CARF, or COA accreditation.