Resources

Behavioral health levels of care

A behavioral health facility contract is a schedule of level-specific rates, not one number: a per diem for detox, a per diem for residential, a program rate for partial hospitalization and intensive outpatient. Each level bills on its own HCPCS and revenue codes, is priced on its own terms, and is only comparable to the same level at another facility. These pages take each level of care from the reimbursement side — what it is in contracting terms, how a day of it bills, what determines the rate a payer pays for it, and how a facility finds out where its own rate stands.

How to read this section

These are reimbursement pages, not clinical ones. The continuum itself — what distinguishes medically managed detox from residential, residential from partial hospitalization — is walked level by level in Levels of care, explained, and the short answers are in the reimbursement FAQ. Each hub here starts from that definition and stays on how the level is paid.

Two things hold on every page. A level bills on a code, but a code is not a rate: a public fee schedule may list one price for a level's code, and a commercial negotiated rate on it is a contract outcome that varies facility to facility (Medicaid fee schedules vs. commercial negotiated rates). And the codes are diagnosis-agnostic: a residential program bills the residential level whatever it treats (there is no eating-disorder billing code). What each code represents, and how revenue codes and HCPCS codes relate on one claim, is on the billing codes pages and in Behavioral health revenue codes, explained.

How each level becomes a comparable rate — extraction, normalization, and level-of-care mapping — is on the coverage and methodology page.

See our methodology

See 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.