The following table lists the HCPCS or CPT procedure codes and modifiers that providers are required to use when submitting claims for intensive in-home mental health and substance abuse treatment services for children.
HCPCS/CPT Code |
Description |
Program Modifier Code |
Enrolled Providers Who May Perform Service |
Service Modifier Code |
ICD-9-CM Diagnoses Allowed* |
Allowable POS Codes | Telehealth Services Covered? |
H0004 |
Behavioral health counseling and therapy, per 15 minutes |
HA Child/adolescent program |
Less than bachelor degree level |
HM |
290.0-298.9; 300.00-316 |
04, 12, 99 | Yes (use "GT" modifier) |
Bachelors degree level |
HN | ||||||
Masters degree level |
HO | ||||||
Doctoral level |
HP | ||||||
QTT |
U6 | ||||||
Psychiatrist |
UA | ||||||
H0022 |
Alcohol and/or drug intervention service (planned facilitation) (60 minutes) |
HA Child/adolescent program |
Less than bachelor degree level |
HM |
303-305.93; 308.9; 309.24; 309.28; 309.9; 312.31 |
04, 12, 99 | Yes (use "GT" modifier) |
Bachelors degree level |
HN | ||||||
Masters degree level |
HO | ||||||
Doctoral level |
HP | ||||||
Psychiatrist |
UA | ||||||
T1006 |
Alcohol and/or substance abuse services, family/couple counseling (60 minutes) (This code should be used only when the primary diagnosis is alcohol or drug abuse related.) |
HA Child/adolescent program |
Less than bachelor degree level |
HM |
303-305.93; 308.9; 309.24; 309.28; 309.9; 312.31 |
04, 12, 99 | Yes (use "GT" modifier) |
Bachelors degree level |
HN | ||||||
Masters degree level |
HO | ||||||
Doctoral level |
HP | ||||||
Psychiatrist |
UA | ||||||
99082 |
Unusual travel (eg, transportation and escort of patient) (60 minutes) |
HA Child/adolescent program |
Less than bachelor degree level |
HM |
290.0-298.9; 300.00-316 |
99** | No |
Bachelors degree level |
HN | ||||||
Masters degree level |
HO | ||||||
Doctoral level |
HP | ||||||
QTT |
U6 | ||||||
Psychiatrist |
UA |
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