In medical billing, H codes are a special set of HCPCS Level II codes used for behavioral health and substance use disorder (SUD) services. These codes are mainly required by Medicaid and state behavioral health programs to ensure accurate billing and reporting.
What Are H Codes?
H codes identify services related to mental health, counseling, and substance abuse treatment. They are used when billing for services provided by non-physician professionals such as counselors, therapists, or social workers.
Common H Codes:
- H0001 – Alcohol and/or drug assessment
- H0004 – Individual counseling, per 15 minutes
- H0015 – Intensive outpatient program for substance use
- H2019 – Therapeutic behavioral services, per 15 minutes
H Codes vs CPT Codes
While CPT codes are used across all medical specialties, H codes are specific to behavioral health. CPT codes are created by the AMA, while H codes come from CMS for Medicaid and public health use.
| Category | H Codes | CPT Codes |
|---|---|---|
| Used for | Behavioral health, SUD | General medical services |
| Maintained by | CMS | AMA |
| Example | H0004 – Counseling | 90832 – Psychotherapy |
Billing Guidelines
To bill correctly with H codes:
- Verify payer requirements – Some payers prefer CPT codes, others require H codes.
- Document time and service type – Many H codes are time-based.
- Check state modifiers – Use modifiers like HA (child program) or HB (adult program) if required.
- Ensure provider credentials – Only qualified professionals may bill specific H codes.
Conclusion
H codes play a vital role in accurately billing behavioral health and substance use services. Proper coding helps providers get timely reimbursement, maintain compliance, and deliver essential care to patients without claim denials.