HCPCS Codes for Mental Health Claims
HCPCS Codes, which stand for Healthcare Common Procedure Coding System, are codes created by the Centers for Medicare and Medicaid Services (CMS) to help identify services rendered and approved by various Medicaid and Medicare programs in the United States.
There are three levels of HCPCS codes:
- Level 1 — Numerical CPT Codes
- Examples: 90791, 90834, 90837
- Level 2 — Alphanumeric Codes, often representing non-physician services not covered by Level 1 codes
- Examples: H0001, H0002, H2020
- Level 3 — Local, state-based codes, often developed by each state’s Medicaid agencies. These codes were discontinued in 2003 as Level 1 and Level 2 codes became standardized nationally.
Most mental health providers only code using Level 1 codes. Some providers working with Medicaid clients are required to use Level 2 alphanumeric codes that are provided by non-physicians.
Below is a list of Level 2 HCPCS codes, their descriptions, duration (when applicable), and service location.
If you are having any problems with coding, Medicaid, or your billing, consider inquiring about our mental health insurance billing service at TheraThink. We can help translate this all into English!
HCPCS Code | Description | Duration | Service Location |
---|---|---|---|
H0001 | Alcohol and/or drug assessment | ||
H0002 | Behavioral health screening to determine eligibility for admission to treatment program | ||
H0003 | Alcohol and/or drug screening; laboratory analysis of specimens for presence of alcohol and/or drugs | ||
H0004 | Behavioral health counseling and therapy | 15 minutes | |
H0005 | Alcohol and/or drug services; group counseling by a clinician | ||
H0006 | Alcohol and/or drug services; case management | ||
H0007 | Alcohol and/or drug services; crisis intervention | Outpatient | |
H0008 | Alcohol and/or drug services; sub-acute detoxification | Hospital Inpatient | |
H0009 | Alcohol and/or drug services; acute detoxification | Hospital Inpatient | |
H0010 | Alcohol and/or drug services; sub-acute detoxification | residential addiction program inpatient | |
H0011 | Alcohol and/or drug services; acute detoxification | residential addiction program inpatient | |
H0012 | Alcohol and/or drug services; sub-acute detoxification | residential addiction program outpatient | |
H0013 | Alcohol and/or drug services; acute detoxification | residential addiction program outpatient | |
H0014 | Alcohol and/or drug services; ambulatory detoxification | ||
H0015 | Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education | ||
H0016 | Alcohol and/or drug services; medical/somatic | Per diem | medical intervention in ambulatory setting |
H0017 | Behavioral health; short-term residential, without room and board | Per diem | hospital residential treatment program |
H0018 | Behavioral health; short-term residential | Per diem | non-hospital residential treatment program |
H0019 | Behavioral health; long-term residential | Per diem | non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days |
H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | ||
H0021 | Alcohol and/or drug training service (for staff and personnel not employed by providers) | ||
H0022 | Alcohol and/or drug intervention service (planned facilitation) | ||
H0023 | Behavioral health outreach service (planned approach to reach a targeted population) | ||
H0024 | Behavioral health prevention information dissemination service (one-way direct or non-direct contact with service audiences to affect knowledge and attitude) | ||
H0025 | Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior) | ||
H0026 | Alcohol and/or drug prevention process service, community-based (delivery of services to develop skills of impactors) | ||
H0027 | Alcohol and/or drug prevention environmental service (broad range of external activities geared toward modifying systems in order to mainstream prevention through policy and law) | ||
H0028 | Alcohol and/or drug prevention problem identification and referral service (e.g., student assistance and employee assistance programs), does not include assessment | ||
H0029 | Alcohol and/or drug prevention alternatives service (services for populations that exclude alcohol and other drug use e.g., alcohol free social events) | ||
H0030 | Behavioral health hotline service | ||
H0031 | Mental health assessment, by non-physician | ||
H0032 | Mental health service plan development by non-physician | ||
H0033 | Oral medication administration, direct observation | ||
H0034 | Medication training and support | Per 15 minutes | |
H0035 | Mental health partial hospitalization, treatment, | Less than 24 hours | Hospital |
H0036 | Community psychiatric supportive treatment, face-to-face, | Per 15 minutes | |
H0037 | Community psychiatric supportive treatment program | Per diem | |
H0038 | Self-help/peer services | Per 15 minutes | |
H0039 | Assertive community treatment, face-to-face | Per 15 minutes | |
H0040 | Assertive community treatment program | Per diem | |
H0041 | Foster care, child, non-therapeutic | Per diem | |
H0042 | Foster care, child, non-therapeutic | Per month | |
H0043 | Supported housing | Per diem | |
H0044 | Supported housing | Per month | |
H0045 | Respite care services, not in the home | Per diem | |
H0046 | Mental health services, not otherwise specified | ||
H0047 | Alcohol and/or other drug abuse services, not otherwise specified | ||
H0048 | Alcohol and/or other drug testing: collection and handling only, specimens other than blood | ||
H0049 | Alcohol and/or drug screening | ||
H0050 | Alcohol and/or drug services, brief intervention | Per 15 minutes | |
H1000 | Prenatal care, at-risk assessment | ||
H1001 | Prenatal care, at-risk enhanced service; antepartum management | ||
H1002 | Prenatal care, at risk enhanced service; care coordination | ||
H1003 | Prenatal care, at-risk enhanced service; education | ||
H1004 | Prenatal care, at-risk enhanced service; follow-up home visit | ||
H1005 | Prenatal care, at-risk enhanced service package (includes h1001-h1004) | ||
H1011 | Non-medical family planning education | ||
H2000 | Family assessment by licensed behavioral health professional for state defined purposes | ||
H2001 | Comprehensive multidisciplinary evaluation | ||
H2010 | Rehabilitation program, per 1/2 day | ||
H2011 | Comprehensive medication services | Per 15 minutes | |
H2012 | Crisis intervention service | Per 15 minutes | |
H2013 | Behavioral health day treatment | Per hour | |
H2014 | Psychiatric health facility service | Per diem | |
H2015 | Skills training and development | Per 15 minutes | |
H2016 | Comprehensive community support services | Per 15 minutes | |
H2017 | Comprehensive community support services | Per diem | |
H2018 | Psychosocial rehabilitation services | Per 15 minutes | |
H2019 | Psychosocial rehabilitation services | Per diem | |
H2020 | Therapeutic behavioral services | Per 15 minutes | |
H2021 | Community-based wrap-around services | Per diem | |
H2022 | Community-based wrap-around services | Per 15 minutes | |
H2023 | Supported employment | Per diem | |
H2024 | Supported employment | Per 15 minutes | |
H2025 | Ongoing support to maintain employment | Per diem | |
H2026 | Ongoing support to maintain employment | Per 15 minutes | |
H2027 | Psychoeducational service | Per 15 minutes | |
H2028 | Sexual offender treatment service | Per 15 minutes | |
H2029 | Sexual offender treatment service | Per diem | |
H2030 | Mental health clubhouse services | Per 15 minutes | |
H2031 | Mental health clubhouse services | Per diem | |
H2032 | Activity therapy | Per 15 minutes | |
H2033 | Multisystemic therapy for juveniles | Per 15 minutes | |
H2034 | Alcohol and/or drug abuse halfway house services | Per diem | |
H2035 | Alcohol and/or other drug treatment program | Per hour | |
H2036 | Alcohol and/or other drug treatment program | Per diem | |
H2037 | Developmental delay prevention activities, dependent child of client | Per 15 minutes |
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