Rehab that takes Medicaid in Texas: what's covered and how to find a program

If you need help now: call 911 in an emergency. In a mental health or substance use crisis, call or text 988, any time. SAMHSA's National Helpline, 1-800-662-4357, is free, confidential and open 24/7 for treatment referrals. Stopping heavy drinking suddenly can be dangerous; see alcohol detox in Texas.

What Texas Medicaid covers for drug and alcohol rehab

Texas Medicaid's substance use benefit is in the Behavioral Health handbook of its provider manual. Outpatient and residential substance use treatment may only be delivered by a chemical dependency treatment facility licensed by HHSC (TMHP notice).

Service	Approval first?	What to know
Assessment	No	The program's assessment decides the level of care.
Outpatient counseling, individual and group	No, up to a yearly limit	TMHP's 2019 notice set the yearly limits at 26 hours of individual and 135 hours of group counseling, with more approved on documented medical necessity.
Outpatient detox	Yes	For mild to moderate withdrawal; can be approved for up to 21 days.
Residential detox	Yes	The program asks for approval and can send the request within 3 business days after you're admitted, so you don't have to wait outside.
Residential treatment	Yes	Since January 1, 2019, more episodes are reviewed for medical necessity instead of capped at a fixed number (HHSC parity findings).
IOP and PHP	Yes, usually	Health plans can offer them in place of a hospital stay. As of November 2025, HHSC had approved 14 plans to offer each.
Medication for addiction	Some products	Part of the benefit. Texas Medicaid has enrolled methadone clinics (opioid treatment programs) since December 14, 2019. Some buprenorphine products need a clinical prior authorization, which the prescriber requests.
Peer specialist services	Ask your plan	Recovery support from a certified peer, for adults 21 and older. See recovery coaching with Texas Medicaid.
Rides	Ask your plan	Medicaid covers rides to appointments if you have no other way to get there (HHSC's transportation program).

What you pay: nothing for covered care. Medicaid members don't pay copays, and HHSC reports no yearly or lifetime dollar limits on the substance use benefit (HHSC parity findings). Approval in advance isn't a promise of payment, and each level of care usually needs its own approval, so ask again when you step down from residential to IOP.

Who can get Texas Medicaid

Texas Medicaid is for certain groups with limited income: children, pregnant women, parents and caretakers with very low income, people with disabilities, and adults 65 and older. Texas hasn't expanded Medicaid to other adults, so most adults 19 to 64 who aren't pregnant, raising a child or disabled can't get it, however low their income. Apply at YourTexasBenefits.com or by calling 2-1-1; see how to apply for Texas Medicaid.

• CHIP covers substance use treatment for children whose families earn too much for Medicaid, and has charged no copays for mental health and substance use office visits or residential treatment since July 1, 2022.
• After a pregnancy, Medicaid for Pregnant Women lasts 12 months, and Healthy Texas Women Plus adds substance use care for the 12 months after a pregnancy for women in Healthy Texas Women.
• Which program you're in (STAR, STAR+PLUS, STAR Kids, STAR Health) and which plan runs it: see Texas Medicaid plans explained.

Inpatient rehab that takes Medicaid

"Inpatient rehab" in most searches means residential treatment: living at a licensed program with care around the clock. Texas Medicaid covers it, and residential detox, at licensed chemical dependency treatment facilities, with prior authorization that the program requests. Residential treatment is also on the list of settings Texas Medicaid health plans may use in place of a hospital (Uniform Managed Care Manual 16.3).

• How long: there's no fixed number of days. The plan approves a block of days and reviews your progress with the program before approving more. When it stops approving residential care, ask what it will cover next, such as PHP or IOP, so there's no gap.
• Long-term rehab that takes Medicaid: Medicaid pays for treatment while it's medically necessary; health plans generally pay for treatment, not housing. After residential treatment, many people step down to outpatient care and live in a sober home, where residents pay rent; see sober living in Texas.
• Hospital care: if withdrawal or a mental health crisis needs a hospital, that's a different benefit. Call 911 or go to an emergency room for a medical emergency.

Not sure you need residential care? Many people do as well in outpatient care: see inpatient vs outpatient rehab.

The 16-bed rule, and where Texas's Medicaid waiver stands

One federal rule shapes which residential programs take Medicaid for adults:

• What it is. Federal Medicaid treats a facility of more than 16 beds that mainly treats mental illness, including substance use disorders, as an "institution for mental diseases" (IMD) (42 CFR 435.1010), and generally won't pay for adults 21 to 64 there (Congressional Research Service). That's why many residential programs have 16 beds or fewer.
• The managed care exception. A state can pay a health plan for a member aged 21 to 64 who spends part of a month in an IMD, when the stay is no more than 15 days in that month (42 CFR 438.6(e)). Texas uses this "in lieu of" option.
• Texas's waiver. Many states use a section 1115 substance use waiver to let Medicaid pay for residential stays in larger programs. As of October 2026, Texas isn't on CMS's list of states with an approved substance use 1115 demonstration (Medicaid.gov). Its broader 1115 waiver, the Texas Healthcare Transformation and Quality Improvement Program, runs through September 2030, and a federal review found that it doesn't cover behavioral health care in an IMD (ASPE, 2021). We found no newer approval that changes this.

What it means for you: if you're 21 to 64, ask a residential program how many beds it has, and ask your plan whether it will pay for your whole stay there. The IMD rule is a Medicaid rule; it doesn't limit private insurance or TRICARE.

Alcohol rehab that takes Medicaid

The same benefit covers alcohol and drug treatment. For alcohol, that usually means:

• Detox when it's needed: outpatient for mild to moderate withdrawal, residential or hospital care when it could be severe. Our alcohol detox guide explains the warning signs.
• Treatment afterward: residential, IOP, PHP or outpatient counseling. What outpatient care involves: outpatient rehab in Texas.
• Medication: the FDA has approved naltrexone, acamprosate and disulfiram for alcohol use disorder. Ask your prescriber which are on the Medicaid drug list, or check the Texas Vendor Drug Program.

Medicaid detox programs by city: Houston, Dallas, San Antonio, Austin and El Paso, or all of Texas.

How to find rehab that takes your Medicaid plan

1. Find your plan's name. It's on your health plan card, in your YourTexasBenefits.com account, or from the enrollment broker at 800-964-2777. "Medicaid" isn't enough: a program may take Superior and Molina but not your plan.
2. Call the plan. Use the member services or behavioral health number on the card. Ask for in-network programs at the level of care you need, near you, and whether that level needs prior authorization.
3. Search. Cima Find Care lists programs that say they accept Medicaid, by level of care and city (below), and by plan: Superior HealthPlan, Molina, Community Health Choice, Wellpoint, Texas Children's Health Plan and Blue Cross Blue Shield Medicaid.
4. Call the program. "Are you in network with my plan for this level of care? Will you request the authorization? When can I start?" Give your plan's member number and your Medicaid ID.
5. If nobody in network can treat you, ask the plan for help. When no network provider can give a covered, medically necessary service, the plan must allow a referral to a Medicaid provider outside its network, requested by one of the plan's providers (TMHP Medicaid Managed Care Handbook). Still stuck? Call the HHS Ombudsman: 866-566-8989 for managed care, or 800-252-8154 for behavioral health.

Be wary of offers. If someone offers free travel, rent or cash to get you into a program, treat it as a warning sign. Paying or receiving anything of value for referrals to treatment or recovery homes is a federal crime (18 U.S.C. 220), and Texas's Patient Solicitation Act bans it too. Going out of state? Ask your Texas plan, in writing, whether it will pay a program there before you go.

Rehab that takes Medicaid near me: Texas programs by city

Counted from the Texas programs on Cima Find Care, from SAMHSA's FindTreatment.gov and the programs' own websites. A listing shows what a program says it accepts; always confirm with the program and your plan.

Level of care	Programs in Texas	Accept Medicaid	Accept Medicare	Accept private insurance	Sliding-scale fee
Detox	131	83	61	123	23
Residential	181	126	86	156	51
PHP (partial hospitalization)	114	63	43	114	17
IOP (intensive outpatient)	160	98	58	137	52
Outpatient	339	224	173	284	111
MAT (medication)	168	111	88	147	45

Counted from Cima Find Care's Texas records as of 2026-10-27: one program per organization, so an organization in several cities counts once (city by city, it counts in each), from SAMHSA's FindTreatment.gov and the programs' own websites. A program counts when any of its locations lists it.

City	Residential	Outpatient
Austin	16 programs, 10 take Medicaid	19 programs, 9 take Medicaid
Dallas	12 programs, 8 take Medicaid	23 programs, 15 take Medicaid
El Paso	8 programs, 8 take Medicaid	16 programs, 9 take Medicaid
Fort Worth	5 programs, 4 take Medicaid	16 programs, 8 take Medicaid
Houston	28 programs, 17 take Medicaid	53 programs, 33 take Medicaid
San Antonio	14 programs, 12 take Medicaid	25 programs, 20 take Medicaid

Statewide Medicaid lists: residential, detox, PHP, IOP, outpatient, medication (MAT), or every level of care. In Houston: residential, IOP and outpatient. In Dallas: residential and IOP. In San Antonio: residential and IOP. In Fort Worth: residential and outpatient.

Rehabs that take Medicaid and Medicare

Many people 65 and older or with disabilities have both, and many of them are in STAR+PLUS. Medicare pays first for the care it covers and Medicaid pays last. Medicare Part A covers a stay in a general or psychiatric hospital and Part B covers outpatient substance use care (Medicare.gov), but many residential programs aren't hospitals, so ask the program whether it takes both for the level of care you need.

No Medicaid: state-funded treatment through OSAR

Texas pays for detox, residential, outpatient and medication treatment for Texans who can't afford it, through programs funded by HHSC. The door is your region's OSAR (Outreach, Screening, Assessment and Referral): call 2-1-1 or 877-541-7905. HHSC says the only requirement to get an OSAR screening is that you live in Texas; the treatment itself is for people whose income qualifies, and some pay part of the cost (HHSC: OSAR). Pregnant women are given preference for admission at programs paid by the federal block grant (45 CFR 96.131). The whole process: free and state-funded rehab in Texas.

What to ask a program that says it takes Medicaid

• Are you in network with my plan (give the name on the card), for this level of care?
• Is your program licensed by HHSC as a chemical dependency treatment facility?
• How many beds do you have, and will my plan pay for my whole stay? (For adults 21 to 64 in residential care.)
• Will you request the prior authorization, and what happens if the plan says no?
• Do you offer, or work with someone who prescribes, medication for alcohol or opioid use disorder?
• What comes after this level, and is the next program in my plan too?
• How soon can I start? If there's a wait, what can I get in the meantime?

Our insurance call script for rehab has the full list of questions for your plan.