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Interpreters for Substance Use Treatment

Treatment for a substance use disorder depends on a patient being able to say exactly what they use, how much and how often, to someone they trust will keep it confidential. With an interpreter, there is a third person in that conversation, and federal confidentiality rules apply to what is said. Here is who must provide the interpreter, how Part 2 bears on it, and how programs and clinicians book one with us.

If the program receives federal health funding, it provides the interpreter, free

You should not have to bring or pay for an interpreter at a treatment program that receives federal financial assistance from HHS (45 CFR 92.2). The Section 1557 rule names residential and community-based treatment facilities among the health programs it covers (92.4); a covered program must offer a qualified interpreter, free of charge, and may not require the patient to provide or pay for one (92.201(b), (c)(1), (e)(1)). It may not rely on a minor child except as an emergency stopgap, or on an adult companion except in an emergency or at the patient's private, documented request with a qualified interpreter present (92.201(e)(2)–(3)) — and in addiction treatment the companion is often part of what the patient needs to talk about.

Confidentiality is governed by a second federal rule, 42 CFR Part 2, which applies to federally assisted substance use disorder programs. "Federally assisted" there includes participating in Medicare, being authorized to provide maintenance treatment or withdrawal management, and being registered to dispense controlled substances for that treatment (42 CFR 2.12(b)), so a program can be outside Section 1557 and still bound by Part 2. Part 2 defines a patient's records as any information, whether recorded or not, that the program creates or receives about the patient (2.11) — which includes what is said in a session through an interpreter. Communications among program personnel who need the information for treatment are not restricted (2.12(c)(3)); communications with an outside service provider are allowed for what it needs to serve the program only if it has signed a written agreement acknowledging it is fully bound by Part 2, a "qualified service organization" agreement (2.11, 2.12(c)(4)). And a facility publicly identified as providing only substance use treatment may acknowledge that someone is a patient there only with written consent or a court order (2.13(c)).

So a patient of a covered program should ask the program for the interpreter. Who books us: programs and counselors that need an interpreter in person for an intake, a group or a family session, or a language their usual service cannot cover; clinicians in private practice treating substance use who receive no federal financial assistance; and residential programs whose family sessions include relatives who speak another language. How a program brings an outside interpreter within Part 2 is a decision for its compliance officer: if your program requires a qualified service organization agreement, or any other paperwork, before an interpreter joins, tell us when you request, and we confirm whether we can meet it before you book. If a specific interpreter credential is required, the same applies.

What confidentiality means for the interpreter in practice

• The interpreter does not confirm that anyone is a patient — not to a relative who calls, not to someone from the patient's community who recognizes them in the waiting room. A qualified interpreter, under the Section 1557 definition, follows interpreter ethics including client confidentiality (45 CFR 92.4); Part 2 adds the rule on acknowledging a patient's presence (42 CFR 2.13(c)).
• No contact outside the session. The interpreter does not call, text or leave voicemails for the patient; the program does any scheduling.
• Fear of being known is sharper here than in most health care: a patient may worry about an employer, a family, an immigration case or a small language community. Give the patient the interpreter's name before the first session. If a remote interpreter from another region would be easier for the patient, tell us, and we will tell you whether we can staff that.
• Send us only what we need to staff the session: the language, date, time, platform or address, and the type of session. Clinical details stay with the program.

The language of use, and the language of recovery

An assessment needs the substance, the amount, the route and the frequency, and patients describe them in slang that varies by country, region and generation. The interpreter renders slang with slang where an equivalent exists, or keeps the patient's word and tells the counselor what it refers to — openly, so the patient hears it too. What the interpreter must not do is clean it up: "I was getting high every day before work" rendered as "I consumed substances daily" loses the frequency, the timing and the patient's own framing. Amounts are a second trap. A "drink" or a "bottle" means different volumes in different countries, and the counselor should ask what size, through the interpreter, rather than assume.

Clinicians choose their words deliberately — "substance use disorder" rather than "addict", "return to use" or "recurrence" rather than "relapse" — and the interpreter renders the word the clinician chose, not a harsher everyday one. Recovery vocabulary such as "sponsor", "higher power", "step work" or "harm reduction" has established translations in some languages and none in others; when it does not carry, the interpreter says so and the counselor explains. Urine drug screen results, take-home doses and dosing schedules are numbers and rules, rendered exactly.

Medication treatment: intake, consent and telehealth

In an opioid treatment program, a practitioner must make sure each patient chooses medication treatment voluntarily, that all relevant facts about it are clearly and adequately explained, and that the patient gives informed consent; a patient who chooses to taper does so with informed consent documented in the record; and services follow a care plan built through shared decision-making between the patient and the clinical team (42 CFR 8.12(e)(1), (e)(3), (f)(1)). Each of those is a conversation the interpreter carries in full: how the medication works, what the dosing visits involve, what happens with a missed dose, what the rules for take-home doses are.

The admission examination may be done by telehealth when a practitioner decides it can be adequate; for methadone, audio-visual telehealth is required unless it is not available to the patient (8.12(f)(2)(v)). An interpreter joining that evaluation should join the same video session, not a separate phone line, so the practitioner sees the patient and hears the interpretation together.

Groups, family sessions and residential programs

• One member who does not speak English in an English-language group: the interpreter sits beside them and interprets the group to them in a low voice while others talk (whispered simultaneous interpreting), then interprets consecutively when they speak. The group should know the interpreter is there and that they are bound by the same confidentiality.
• Several members who share a language are usually better served by a group run in that language through an interpreter, or by their own group, than by one whispered rendering.
• Family sessions often include relatives who speak only the family's language, sometimes abroad on video. Each language needs its own interpreter, and the family should hear the patient's words, not a relative's summary of them.
• Residential programs tend to need an interpreter in person for intake and family weekends, and by video for daily counseling.

Booking treatment sessions

By video or phone it is $80 per interpreter per hour from the scheduled start, one-hour minimum: a weekly individual session is $80, four a month $320. In person it is $110 an hour with a two-hour minimum, plus travel at $0.70 per mile from the interpreter's location, confirmed before you book: a weekly 90-minute group in person is billed at the two-hour minimum, $220, so four groups a month are $880 plus travel. An in-person intake and assessment of three hours is $330 plus travel; the same by video is $240. A family day running from 9 a.m. to 4 p.m. is seven hours, $770 in person, and may need two interpreters in relay; ask when you request.

Send with the request: the type of program (outpatient, intensive outpatient, opioid treatment program, residential), the type of session (intake, individual, group, family, medication visit), the standing day and time for a series, the platform or address, the patient's language and country, and any agreement the program requires before an interpreter joins. Records a program needs to send in another language are a separate written service at $24.95 per page certified; Part 2 governs whether and how they may be disclosed.

By video, by phone or in person

Virtual interpreting runs on Zoom, Google Meet or Microsoft Teams, or over the telephone. It is quicker to arrange, costs less and carries no travel charge, and it suits appointments, calls and most meetings.

In person is what venues with their own rules tend to expect, and the right choice when documents are being signed or several people are speaking at once. Tell us the platform, or the city and the venue, when you send the request.

Languages

The standard-availability languages are: Spanish, Portuguese, French, Mandarin, Cantonese, Arabic, Russian, Korean, Vietnamese, Haitian Creole, Polish, Italian, German, Japanese, Hindi, Urdu, Persian, Turkish, Ukrainian, Tagalog, Bengali, Punjabi, Gujarati, Tamil, Armenian, Greek, Hebrew, Romanian, Serbian, Bosnian, Somali and Nepali. Every other language we offer carries the 25–30% limited-availability rate. If a language is not on that list it is not because we cannot do it — it is because the pool of qualified interpreters in the United States is small enough that we will not promise a date without checking.

Each language has its own page on what to watch for — dialects, names, dates, who the speakers usually are: see interpreters by language.

What it costs

Rates are per interpreter, per hour, and billed from the scheduled start time rather than from when everyone actually arrives.

• Virtual — $80 per hour, one-hour minimum. Zoom, Google Meet, Teams or telephone.
• In person — $110 per hour, two-hour minimum.
• Limited-availability languages — add 25–30%. Which languages those are is listed below rather than left vague.
• Travel for in-person work — $0.70 per mile from the interpreter's location.

How the travel charge works out

Travel is charged at $0.70 per mile from the interpreter's location, which means you can work it out rather than wait for a quote: a 20-mile round trip is $14, a 60-mile round trip is $42, a 150-mile round trip is $105. There is no separate call-out fee on top.

We will not pretend to know in advance where the interpreter will be coming from — that depends on the language, the date and the venue. What we do is confirm the interpreter and the exact travel figure before you book, so it is never a surprise on the invoice. Virtual assignments carry no travel charge at all, which is one reason most of what we do is virtual.

How booking an interpreter works

• You send the request with the form below: the language, the setting, the format, the date and how long it should last.
• We confirm before you commit: the interpreter, the exact price and the travel figure if there is one. We reply the same business day, and no payment is taken at this stage.
• You confirm, and the interpreter is booked for your date.

What to have ready

The more of this comes in the first message, the fewer exchanges before you have a price:

• The language, the date, the start time and how long it should run.
• Virtual or in person: the platform, or the city and the venue.
• The setting and the subject matter.
• How many people need interpreting for.
• Any credential the venue requires of the interpreter.

Request an interpreter

Tell us the date, the language and the setting and we will come back with the interpreter, the exact price and the travel figure if there is one — before you commit to anything.

Sources

What this page says about the rules was checked against these official sources on October 28, 2026. Rules change; the source is always the authority.

• 42 CFR 2.11 — Confidentiality of SUD patient records: Definitions, including records and qualified service organization (eCFR; as amended Feb. 16, 2024, 89 FR 12472)
• 42 CFR 2.12 — Confidentiality of SUD patient records: Applicability, federal assistance and exceptions (eCFR)
• 42 CFR 2.13 — Confidentiality of SUD patient records: Confidentiality restrictions and safeguards (eCFR)
• 42 CFR 8.12 — Federal opioid use disorder treatment standards for opioid treatment programs (eCFR)
• 45 CFR 92.201 — Section 1557: Meaningful access for individuals with limited English proficiency (eCFR; rule of May 6, 2024)
• 45 CFR 92.4 — Section 1557 definitions: health program or activity, qualified interpreter (eCFR)
• 45 CFR 92.2 — Section 1557: Application to health programs receiving HHS financial assistance (eCFR)

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