Opioid Use Disorder Diagnoses Rose Nearly 33 Percent Among Commercially Insured Patients From 2022 to 2025

The number of commercially insured patients receiving diagnoses of opioid use disorder climbed 32.7 percent nationally between 2022 and 2025, according to FAIR Health, a nonprofit health data organization that maintains one of the largest repositories of commercial healthcare claims in the United States. In 2022, there were 449 patients with opioid use disorder diagnoses per 100,000 patients receiving medical services. By 2025, that figure had risen to 596 per 100,000. The finding was released on October 14, 2026, as part of the annual update of FAIR Health’s Opioid Tracker, a free interactive tool that maps opioid use disorder among commercially insured patients both nationally and state by state. A companion brief published at the same time offers a user’s guide to navigating the tracker.

The Opioid Tracker is built on FAIR Health’s repository of commercial health claims, which grows by more than five billion validated medical services each year. The tool’s central feature is a heat map representing patients with opioid use disorder diagnoses per 100,000 patients receiving medical services in 2025 for each state. Clicking on any state opens an infographic for that state with 2025 data, including the top five procedure code categories by utilization, the top five procedure codes by aggregate allowed amounts, the change in the number of patients with opioid use disorder diagnoses per 100,000 patients from 2022 to 2025, and the distribution of patients by age and gender. A similar infographic exists for the nation as a whole, supplemented by a second national infographic showing the top five states for opioid use disorder diagnoses, the fastest-growing specialties, the distribution of places of service, and service type, whether professional or facility, as a percentage of total allowed amounts.

Among the most striking state-level results is the concentration of opioid use disorder diagnoses in the South and Appalachia. In 2025, Tennessee had the highest rate of commercially insured patients receiving treatment for opioid use disorder, with 1,551 patients with such a diagnosis per 100,000 patients, compared with 596 per 100,000 nationally. Tennessee was followed by West Virginia at 1,528 patients per 100,000, Mississippi at 1,373, Arkansas at 1,320 and Delaware at 1,256. These rates run roughly two to two and a half times the national average, underscoring how unevenly the burden of opioid use disorder is distributed across the country and how state-level data can reveal patterns that national averages obscure.

The tracker also sheds light on what kinds of services patients with opioid use disorder actually receive. Nationally in 2025, alcohol and substance abuse services and treatments constituted the procedure code category with the highest utilization for opioid use disorder among commercially insured patients, representing 39.0 percent of all claim lines with an opioid use disorder diagnosis. A claim line is an individual service or procedure listed on an insurance claim, so this percentage reflects the relative frequency of substance abuse treatment services across the enormous volume of billed care associated with the diagnosis. The dominance of this category suggests that counseling and behavioral health interventions remain the most commonly billed components of opioid use disorder care in commercial insurance populations.

When it comes to spending, one specific code stands out. Nationally in 2025, G2067, the weekly bundle for medication-assisted treatment with methadone, was the procedure code with the highest aggregate allowed amount for opioid use disorder among commercially insured patients, accounting for 9.4 percent of aggregate allowed amounts for that diagnosis. The average allowed amount for this code was $243. An allowed amount is the total negotiated, in-network fee paid to the provider under an insurance plan, including the portion paid by the health plan and the part the patient pays under the plan’s in-network cost-sharing provisions such as copays or coinsurance once the deductible has been met. The aggregate allowed amount for a given procedure is the sum of all allowed amounts for that procedure in the applicable geographic area during the time frame. That a methadone treatment bundle tops the spending hierarchy highlights the central role that medication-assisted treatment now plays in the economics of opioid use disorder care.

Demographic patterns in the tracker point to who is most affected. The highest percentage of opioid use disorder diagnoses among commercially insured patients was attributable to patients in the 41 to 50 age group, which made up 28.1 percent of the total age distribution in 2025 across the nation. Gender distribution showed males at 56.1 percent of commercially insured patients with opioid use disorder diagnoses nationally in 2025, while females accounted for 43.9 percent. These distributions matter for clinicians and policymakers because they indicate which populations treatment systems must be designed to reach, and they can be compared over time and across states as the tracker is updated annually.

Perhaps the most revealing trend involves which kinds of clinicians are treating the growing patient population. The fastest-growing specialty involved in the treatment of opioid use disorder nationally in 2025 was nurse practitioner, which increased 67 percent in percent of claim lines from 2022 to 2025. In second and third positions, respectively, were psychiatric nurse, which grew 47 percent, and emergency medicine, which grew 44 percent. The rapid rise of nursing professionals in this field suggests that the expansion of treatment capacity for opioid use disorder is being driven substantially by advanced practice nurses, a development with significant implications for workforce planning, scope-of-practice policy and access to care in states where physicians alone cannot meet demand.

The distinction between professional and facility services, tracked as a percentage of total allowed amounts in the second national infographic, adds another layer to the picture. Because the tracker separates places of service and service type, users can see whether opioid use disorder care is being delivered predominantly in office-based professional settings or in facility settings such as hospitals and treatment centers. This kind of granularity is unusual for publicly available opioid data and reflects the underlying depth of FAIR Health’s claims repository, which is a national Qualified Entity certified by CMS and also receives all claims for individuals enrolled in traditional Medicare Parts A, B and D. The organization’s data products, including pricing benchmarks and custom analytics, are used by commercial insurers and self-insurers, providers, hospitals and healthcare systems, government agencies and researchers, and its data has been designated an official source for state health programs including workers’ compensation and personal injury protection programs as well as surprise billing laws.

For the public, FAIR Health also operates a free consumer website and mobile app, available in English and Spanish, that enable consumers to estimate and plan for healthcare expenses and offer educational resources on health insurance. The website has been recognized by the White House Summit on Smart Disclosure, the Agency for Healthcare Research and Quality, URAC, the eHealthcare Leadership Awards, appPicker, Employee Benefit News and Kiplinger’s Personal Finance. The organization’s mission is to supply objective, unbiased information for all stakeholders to improve healthcare quality, access and affordability, and the Opioid Tracker is one expression of that mission in the domain of the opioid crisis.

The 32.7 percent rise in opioid use disorder diagnoses among commercially insured patients from 2022 to 2025, from 449 to 596 per 100,000, is a headline number that will draw attention, but the tracker’s real value lies in the detail beneath it: the state heat map that shows Tennessee leading the nation at 1,551 per 100,000, the procedure code data that reveals methadone medication-assisted treatment as the largest spending category at 9.4 percent of aggregate allowed amounts, the age and gender distributions that identify the 41 to 50 group as the largest affected cohort, and the specialty trends that show nurse practitioners expanding their role in opioid use disorder treatment faster than any other specialty. As the opioid epidemic continues to evolve, tools like the Opioid Tracker provide the granular, claims-based evidence that researchers, insurers, providers and government agencies need to understand where the crisis is concentrated, how treatment is being delivered and which parts of the healthcare workforce are carrying the response.

Subject of Research: Opioid use disorder diagnoses among commercially insured patients in the United States

Article Title: Patients with opioid use disorder diagnoses increased almost 33 percent from 2022 to 2025

Article References: Patients with opioid use disorder diagnoses increased almost 33 percent from 2022 to 2025. (n.d.). Original publication

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Keywords: Patients, opioid, disorder, diagnoses, increased, almost, percent, scientific research