Studies suggest that Contingency Management (CM) might be particularly helpful for those who have tried recovery before without success or during times that patients tend to be at highest risk of dropping out of treatment. CM is often recommended when a patient is starting a new treatment episode or when they are newly inducted on medication such as methadone or buprenorphine. CM tends to be most effective for patients who are struggling with the target behavior - for instance, patients who are struggling with abstinence are most likely to benefit from CM targeting abstinence. In contrast, patients who are struggling with attendance are most likely to benefit from CM targeting attendance. Because CM requires a financial investment, it is generally not recommended for programs that already have very high success rates, as the investment is unlikely to yield a significant incremental benefit.

CM is not recommended in settings where toxicology screening results could lead to punitive outcomes. For example, in the Veterans Health Administration CM initiative, veterans were not offered CM if a positive toxicology screening could result in loss of housing.