Behavioral health billing codes
Behavioral health facilities are paid on a small set of HCPCS codes and revenue codes — a per diem for detox, a per diem for residential, a program rate for PHP or IOP. The same code can carry very different negotiated rates from one facility to the next, and payers differ on whether they key a rate to the HCPCS code, the revenue code, or the two together. These pages explain what each code represents, what bills under it, which revenue codes it appears with, and why a rate on it is only comparable to another rate on it when the rest of the contract matches. HCPCS and revenue codes only.
The codes
Facility-level codes first — the lines most behavioral health contracts are built around.
Sub-acute detoxification
The residential detox per-diem code. Pairs with revenue code 0126; the code behind most “detox reimbursement rate” questions.
Read the guideShort-term residential
The behavioral health residential per-diem code, without room and board. Pairs with revenue codes 1002 and 1001; carries every residential program, whatever the diagnosis.
Read the guideHow to read this section
Two things hold across every page here. First, a code is not a rate: a public fee schedule may list one price for H0010, but a commercial negotiated rate on H0010 is a contract outcome that varies facility to facility (Medicaid fee schedules vs. commercial negotiated rates). Second, codes are diagnosis-agnostic: H0018 is the residential per diem for a substance-use program and an eating-disorder program alike (there is no eating-disorder billing code).
More codes — the PHP and IOP program codes and the revenue codes behavioral health facilities bill — are coming to this section.
How these codes become comparable rates — extraction, normalization, and level-of-care mapping — is on the coverage and methodology page.
See our methodologySee where your facility's rates rank.
A free rate analysis compares your contract to actual negotiated rates in your market, by level of care and code.