> APPROVED HCPCS AND CPT CODES AND MODIFIERS

**RELATING TO SUBSTANCE ABUSE TREATMENT, MENTAL HEALTH, AND BEHAVIORAL
HEALTH**[^1]

**(As of May 16, 2005)**

+---------------------------------+------------------------------------+
| **CODE**                        | # Description                      |
+---------------------------------+------------------------------------+
| G0176                           | Activity therapy, such as music,   |
|                                 | dance, art or play therapies not   |
|                                 | for recreation, related to the     |
|                                 | care and treatment of patient\'s   |
|                                 | disabling mental health problems,  |
|                                 | per session (45 min. or more)      |
+---------------------------------+------------------------------------+
| G0177                           | Training and educational services  |
|                                 | related to the care and treatment  |
|                                 | of patient\'s disabling mental     |
|                                 | health problems per session (45    |
|                                 | min. or more)                      |
+---------------------------------+------------------------------------+
| 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, per 15 min.               |
+---------------------------------+------------------------------------+
| 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     |
|                                 | (treatment program that operates   |
|                                 | at least 3 hours/day and a 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 (medical           |
|                                 | intervention in ambulatory         |
|                                 | setting)                           |
+---------------------------------+------------------------------------+
| H0017                           | Behavioral health; residential     |
|                                 | (hospital residential treatment    |
|                                 | program), without room and board,  |
|                                 | per diem                           |
+---------------------------------+------------------------------------+
| H0018                           | Behavioral health; short-term      |
|                                 | residential (non-hospital          |
|                                 | residential treatment program)     |
|                                 | without room and board, per diem   |
+---------------------------------+------------------------------------+
| H0019                           | Behavioral health; long term       |
|                                 | residential (non-medical,          |
|                                 | non-acute care in a residential    |
|                                 | treatment program where stay is    |
|                                 | typically longer than 30 days),    |
|                                 | without room and board, per diem   |
+---------------------------------+------------------------------------+
| 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 deliver   |
|                                 | skills of impactors)               |
+---------------------------------+------------------------------------+
| H0027                           | Alcohol and/or drug prevention     |
|                                 | environmental service (broad range |
|                                 | of external activities geared      |
|                                 | toward modifying systems in order  |
|                                 | to main stream 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 min.                        |
+---------------------------------+------------------------------------+
| H0035                           | Mental health partial              |
|                                 | hospitalization treatment, less    |
|                                 | than 24-hours                      |
+---------------------------------+------------------------------------+
| H0036                           | Community psychiatric supportive   |
|                                 | treatment, face to face, per 15    |
|                                 | min.                               |
+---------------------------------+------------------------------------+
| H0037                           | Community psychiatric supportive   |
|                                 | treatment program, per diem        |
+---------------------------------+------------------------------------+
| H0038                           | Self-help/peer services per 15     |
|                                 | min.                               |
+---------------------------------+------------------------------------+
| H0039                           | Assertive community treatment,     |
|                                 | face-to-face, per 15 min.          |
+---------------------------------+------------------------------------+
| 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         |
|                                 | (Reworded)                         |
+---------------------------------+------------------------------------+
|                                 |                                    |
+---------------------------------+------------------------------------+
| H2001                           | Rehabilitation program, per ½ day  |
+---------------------------------+------------------------------------+
| H2010                           | Comprehensive medication services, |
|                                 | per 15 min.                        |
+---------------------------------+------------------------------------+
| H2011                           | Crisis intervention service, per   |
|                                 | 15 min.                            |
+---------------------------------+------------------------------------+
| H2012                           | Behavioral health day treatment,   |
|                                 | per hour                           |
+---------------------------------+------------------------------------+
| H2013                           | Psychiatric health facility        |
|                                 | service, per diem                  |
+---------------------------------+------------------------------------+
| H2014                           | Skills training and development,   |
|                                 | per 15 min.                        |
+---------------------------------+------------------------------------+
| H2015                           | Comprehensive community support    |
|                                 | services, per 15 min.              |
+---------------------------------+------------------------------------+
| H2016                           | Comprehensive community support    |
|                                 | services, per diem                 |
+---------------------------------+------------------------------------+
| H2017                           | Psychosocial rehabilitation        |
|                                 | services, per 15 min.              |
+---------------------------------+------------------------------------+
| H2018                           | Psychosocial rehabilitation        |
|                                 | services, per diem                 |
+---------------------------------+------------------------------------+
| H2019                           | Therapeutic behavioral services,   |
|                                 | per 15 min.                        |
+---------------------------------+------------------------------------+
| H2020                           | Therapeutic behavioral services,   |
|                                 | per diem                           |
+---------------------------------+------------------------------------+
| H2021                           | Community-based wrap-around        |
|                                 | services, per 15 min.              |
+---------------------------------+------------------------------------+
| H2022                           | Community-based wrap-around        |
|                                 | services, per diem                 |
+---------------------------------+------------------------------------+
| H2023                           | Supported employment, per 15 min.  |
+---------------------------------+------------------------------------+
| H2024                           | Supported employment, per diem     |
+---------------------------------+------------------------------------+
| H2025                           | Ongoing support to maintain        |
|                                 | employment, per 15 min.            |
+---------------------------------+------------------------------------+
| H2026                           | Ongoing support to maintain        |
|                                 | employment, per diem               |
+---------------------------------+------------------------------------+
| H2027                           | Psycho-educational service, per 15 |
|                                 | min.                               |
+---------------------------------+------------------------------------+
| H2028                           | Sexual offender treatment service, |
|                                 | per 15 min.                        |
+---------------------------------+------------------------------------+
| H2029                           | Sexual offender treatment service, |
|                                 | per diem                           |
+---------------------------------+------------------------------------+
| H2030                           | Mental health clubhouse services,  |
|                                 | per 15 min.                        |
+---------------------------------+------------------------------------+
| H2031                           | Mental health clubhouse services,  |
|                                 | per diem                           |
+---------------------------------+------------------------------------+
| H2032                           | Activity therapy, per 15 min.      |
+---------------------------------+------------------------------------+
| H2033                           | Multisystemic therapy for          |
|                                 | juveniles, per 15 min.             |
+---------------------------------+------------------------------------+
| H2034                           | Alcohol and/or drug abuse halfway  |
|                                 | house services, per diem           |
+---------------------------------+------------------------------------+
| H2035                           | Alcohol and/or drug treatment      |
|                                 | program per hour                   |
+---------------------------------+------------------------------------+
| H2036                           | Alcohol and/or drug treatment      |
|                                 | program, per diem                  |
+---------------------------------+------------------------------------+
| H2037                           | Developmental delay, prevention    |
|                                 | activities, dependent child of     |
|                                 | client, per 15 min.                |
+---------------------------------+------------------------------------+
|                                 |                                    |
+---------------------------------+------------------------------------+
| J1230                           | Injection, methadone HCL, up to 10 |
|                                 | mg                                 |
+---------------------------------+------------------------------------+
| M0064                           | Brief office visit for the sole    |
|                                 | purpose of monitoring or changing  |
|                                 | drug prescriptions used in the     |
|                                 | treatment of mental psychoneurotic |
|                                 | and personality disorders          |
+---------------------------------+------------------------------------+
| S0201                           | Partial hospitalization services,  |
|                                 | less than 24 hours, per diem       |
+---------------------------------+------------------------------------+
| S5100                           | Day care services, adult; per 15   |
|                                 | min.                               |
+---------------------------------+------------------------------------+
| S5101                           | Day care services, adult; per half |
|                                 | day                                |
+---------------------------------+------------------------------------+
| S5102                           | Day care services, adult; per diem |
+---------------------------------+------------------------------------+
|                                 |                                    |
+---------------------------------+------------------------------------+
| S5145                           | Foster care, child, per diem       |
+---------------------------------+------------------------------------+
| S5146                           | Foster care, child, per month      |
+---------------------------------+------------------------------------+
| S9475                           | Ambulatory setting substance abuse |
|                                 | treatment or detoxification        |
|                                 | services, per diem                 |
+---------------------------------+------------------------------------+
| S9480                           | Intensive outpatient psychiatric   |
|                                 | services, per diem                 |
+---------------------------------+------------------------------------+
| S9484                           | Crisis intervention mental health  |
|                                 | services, per hour                 |
+---------------------------------+------------------------------------+
| S9485                           | Crisis intervention, mental health |
|                                 | services, per diem (existing)      |
+---------------------------------+------------------------------------+
| S9976                           | Lodging, per diem, not otherwise   |
|                                 | specified                          |
+---------------------------------+------------------------------------+
| T1006                           | Alcohol and/or substance abuse     |
|                                 | services, family/couple counseling |
+---------------------------------+------------------------------------+
| T1007                           | Alcohol and/or substance abuse     |
|                                 | services, treatment plan           |
|                                 | development and/or modification    |
+---------------------------------+------------------------------------+
| T1008                           | Day treatment for individual       |
|                                 | alcohol and/or substance abuse     |
|                                 | services                           |
+---------------------------------+------------------------------------+
| T1009                           | Child sitting services for the     |
|                                 | children of the individual         |
|                                 | receiving alcohol and/or substance |
|                                 | abuse                              |
+---------------------------------+------------------------------------+
| T1010                           | Meals for individuals receiving    |
|                                 | alcohol and/or substance abuse     |
|                                 | services (when meals are not       |
|                                 | included in the program)           |
+---------------------------------+------------------------------------+
| T1011                           | Alcohol and/or substance abuse     |
|                                 | services, not otherwise classified |
+---------------------------------+------------------------------------+
| T1012                           | Alcohol and/or substance abuse     |
|                                 | services, skills development       |
+---------------------------------+------------------------------------+
| T1013                           | Sign language or oral interpreter  |
|                                 | for alcohol and/or substance abuse |
|                                 | services                           |
+---------------------------------+------------------------------------+
| T1025                           | Intensive, extended                |
|                                 | multidisciplinary services         |
|                                 | provided in a clinic setting to    |
|                                 | children with complex medical,     |
|                                 | physical, mental and psychosocial  |
|                                 | impairments, per diem              |
+---------------------------------+------------------------------------+
| T1026                           | Intensive, extended                |
|                                 | multidisciplinary services         |
|                                 | provided in a clinic setting to    |
|                                 | children with complex medical,     |
|                                 | physical, medical and psychosocial |
|                                 | impairments, per hour              |
+---------------------------------+------------------------------------+
| T2010                           | Preadmission Screening and         |
|                                 | Resident Review (PASRR) Level I    |
|                                 | identification screening, per      |
|                                 | screen                             |
+---------------------------------+------------------------------------+
| T2011                           | Preadmission Screening and         |
|                                 | Resident Review (PASRR) Level II   |
|                                 | evaluation, per evaluation         |
+---------------------------------+------------------------------------+
| T2034                           | Crisis intervention waiver, per    |
|                                 | diem                               |
+---------------------------------+------------------------------------+
|                                 |                                    |
+---------------------------------+------------------------------------+
| T2048                           | Behavioral health; long-term care  |
|                                 | residential (non-acute care in a   |
|                                 | residential treatment program      |
|                                 | where stay is typically longer     |
|                                 | than 30 days), with room and       |
|                                 | board, per diem                    |
+---------------------------------+------------------------------------+
| 0900                            | Behavioral health treatment        |
|                                 | services; general classification   |
+---------------------------------+------------------------------------+
| 0901                            | Behavioral health treatment        |
|                                 | services; electroshock treatment   |
+---------------------------------+------------------------------------+
| 0902                            | Behavioral health treatment        |
|                                 | services; milieu treatment         |
+---------------------------------+------------------------------------+
| 0903                            | Behavioral health treatment        |
|                                 | services; play therapy             |
+---------------------------------+------------------------------------+
| 0904                            | Behavioral health treatment        |
|                                 | services; activity therapy         |
+---------------------------------+------------------------------------+
| 0905                            | Behavioral health treatment        |
|                                 | services; intensive outpatient     |
|                                 | services-psychiatric               |
+---------------------------------+------------------------------------+
| 0906                            | Behavioral health treatment        |
|                                 | services; intensive outpatient     |
|                                 | services-chemical dependency       |
+---------------------------------+------------------------------------+
| 0907                            | Behavioral health treatment        |
|                                 | services; community behavioral     |
|                                 | health program (day treatment)     |
+---------------------------------+------------------------------------+
| 0909                            | Behavioral health treatment        |
|                                 | services; other behavioral health  |
|                                 | treatment                          |
+---------------------------------+------------------------------------+
|                                 |                                    |
+---------------------------------+------------------------------------+
|                                 |                                    |
+---------------------------------+------------------------------------+
| Revenue Code 091X               | Revenue Code 091X, originally      |
|                                 | "Psychiatric/psychological         |
|                                 | services", was renamed "Behavioral |
|                                 | health treatment/services"         |
+---------------------------------+------------------------------------+
|                                 |                                    |
+---------------------------------+------------------------------------+
| 1000                            | Behavioral health accommodation;   |
|                                 | general classification             |
+---------------------------------+------------------------------------+
| 1001                            | Behavioral health accommodation;   |
|                                 | residential treatment              |
|                                 | (psychiatric)                      |
+---------------------------------+------------------------------------+
| 1002                            | Behavioral health accommodation;   |
|                                 | residential treatment (chemical    |
|                                 | dependency)                        |
+---------------------------------+------------------------------------+
| 1003                            | Behavioral health accommodation;   |
|                                 | supervised living                  |
+---------------------------------+------------------------------------+
| 1004                            | Behavioral health accommodation;   |
|                                 | halfway house                      |
+---------------------------------+------------------------------------+
| #### 1005                       | #### Behaviora                     |
|                                 | l health accommodation; group home |
+---------------------------------+------------------------------------+
| Subcategory 4                   | Subcategory 4, "Psychiatric", was  |
|                                 | changed to "Behavioral health" for |
|                                 | all other accommodation codes      |
+---------------------------------+------------------------------------+
| #### **CPT-4^®^ Codes**         |                                    |
+---------------------------------+------------------------------------+
| 90801                           | Psychiatric diagnostic interview   |
|                                 | examination                        |
+---------------------------------+------------------------------------+
| 90802                           | Interactive psychiatric diagnostic |
|                                 | interview examination using play   |
|                                 | equipment, physical devices,       |
|                                 | language interpreter, or other     |
|                                 | mechanisms of communication        |
+---------------------------------+------------------------------------+
| 90804                           | Individual psychotherapy, insight  |
|                                 | oriented, behavior modifying       |
|                                 | and/or supportive, in an office or |
|                                 | outpatient facility, approx. 20 to |
|                                 | 30 min. face-to-face with the      |
|                                 | patient                            |
+---------------------------------+------------------------------------+
| 90805                           | Individual psychotherapy, insight  |
|                                 | oriented, behavior modifying       |
|                                 | and/or supportive, in an office or |
|                                 | outpatient facility with medical   |
|                                 | evaluation and management          |
|                                 | services, approx. 20 to 30 min.    |
|                                 | face-to-face with the patient      |
+---------------------------------+------------------------------------+
| 90806                           | Individual psychotherapy, insight  |
|                                 | oriented, behavior modifying       |
|                                 | and/or supportive, in an office or |
|                                 | outpatient facility, approx. 45 to |
|                                 | 50 min. face-to- face with the     |
|                                 | patient                            |
+---------------------------------+------------------------------------+
| 90807                           | Individual psychotherapy, insight  |
|                                 | oriented, behavior modifying       |
|                                 | and/or supportive, in an office or |
|                                 | outpatient facility with medical   |
|                                 | evaluation and management          |
|                                 | services, approx. 45 to 50 min.    |
|                                 | face-to- face with the patient     |
+---------------------------------+------------------------------------+
| 90808                           | Individual psychotherapy, insight  |
|                                 | oriented, behavior modifying       |
|                                 | and/or supportive, in an office or |
|                                 | outpatient facility, approx. 75 to |
|                                 | 80 min. face-to-face with the      |
|                                 | patient                            |
+---------------------------------+------------------------------------+
| 90809                           | Individual psychotherapy, insight  |
|                                 | oriented, behavior modifying       |
|                                 | and/or supportive, in an office or |
|                                 | outpatient facility with medical   |
|                                 | evaluation and management          |
|                                 | services, approx. 75 to 80 min.    |
|                                 | face-to-face with the patient      |
+---------------------------------+------------------------------------+
| 90810                           | Individual psychotherapy,          |
|                                 | interactive, using play equipment, |
|                                 | physical devices, language         |
|                                 | interpreter, or other mechanisms   |
|                                 | of non-verbal communication, in an |
|                                 | office or outpatient facility,     |
|                                 | approx. 20 to 30 min. face-to-face |
|                                 | with the patient                   |
+---------------------------------+------------------------------------+
| 90811                           | Individual psychotherapy,          |
|                                 | interactive, using play equipment, |
|                                 | physical devices, language         |
|                                 | interpreter, or other mechanisms   |
|                                 | of non-verbal communication, in an |
|                                 | office or outpatient facility with |
|                                 | medical evaluation and management  |
|                                 | services, approx. 20 to 30 min.    |
|                                 | face-to-face with the patient      |
+---------------------------------+------------------------------------+
| 90812                           | Individual psychotherapy,          |
|                                 | interactive, using play equipment, |
|                                 | physical devices, language         |
|                                 | interpreter, or other mechanisms   |
|                                 | of non-verbal communication, in an |
|                                 | office or outpatient facility,     |
|                                 | approx. 45 to 50 min. face-to-face |
|                                 | with the patient                   |
+---------------------------------+------------------------------------+
| 90813                           | Individual psychotherapy,          |
|                                 | interactive, using play equipment, |
|                                 | physical devices, language         |
|                                 | interpreter, or other mechanisms   |
|                                 | of non-verbal communication, in an |
|                                 | office or outpatient facility with |
|                                 | medical evaluation and management  |
|                                 | services, approx. 45 to 50 min.    |
|                                 | face-to-face with the patient      |
+---------------------------------+------------------------------------+
| 90814                           | Individual psychotherapy,          |
|                                 | interactive, using play equipment, |
|                                 | physical devices, language         |
|                                 | interpreter, or other mechanisms   |
|                                 | of non-verbal communication, in an |
|                                 | office or outpatient facility,     |
|                                 | approx. 75 to 80 min. face-to-face |
|                                 | with the patient                   |
+---------------------------------+------------------------------------+
| 90815                           | Individual psychotherapy,          |
|                                 | interactive, using play equipment, |
|                                 | physical devices, language         |
|                                 | interpreter, or other mechanisms   |
|                                 | of non-verbal communication, in an |
|                                 | office or outpatient facility with |
|                                 | medical evaluation and management  |
|                                 | services, approx. 75 to 80 min.    |
|                                 | face-to-face with the patient      |
+---------------------------------+------------------------------------+
| 90816                           | Individual psychotherapy, insight  |
|                                 | oriented, behavior modifying       |
|                                 | and/or supportive, in an inpatient |
|                                 | hospital, partial hospital or      |
|                                 | residential care setting, approx.  |
|                                 | 20 to 30 min. face-to-face with    |
|                                 | the patient                        |
+---------------------------------+------------------------------------+
| 90817                           | Individual psychotherapy, insight  |
|                                 | oriented, behavior modifying       |
|                                 | and/or supportive, in an inpatient |
|                                 | hospital, partial hospital or      |
|                                 | residential care setting with      |
|                                 | medical evaluation and management  |
|                                 | services, approx. 20 to 30 min.    |
|                                 | face-to-face with the patient      |
+---------------------------------+------------------------------------+
| 90818                           | Individual psychotherapy, insight  |
|                                 | oriented, behavior modifying       |
|                                 | and/or supportive, in an inpatient |
|                                 | hospital, partial hospital or      |
|                                 | residential care setting, approx.  |
|                                 | 45 to 50 min. face-to-face with    |
|                                 | the patient                        |
+---------------------------------+------------------------------------+
| 90819                           | Individual psychotherapy, insight  |
|                                 | oriented, behavior modifying       |
|                                 | and/or supportive, in an inpatient |
|                                 | hospital, partial hospital or      |
|                                 | residential care setting with      |
|                                 | medical evaluation and management  |
|                                 | services, approx. 45 to 50 min.    |
|                                 | face-to-face with the patient      |
+---------------------------------+------------------------------------+
| 90821                           | Individual psychotherapy, insight  |
|                                 | oriented, behavior modifying       |
|                                 | and/or supportive, in an inpatient |
|                                 | hospital, partial hospital or      |
|                                 | residential care setting, approx.  |
|                                 | 75 to 80 min. face-to-face with    |
|                                 | the patient                        |
+---------------------------------+------------------------------------+
| 90822                           | Individual psychotherapy, insight  |
|                                 | oriented, behavior modifying       |
|                                 | and/or supportive, in an inpatient |
|                                 | hospital, partial hospital or      |
|                                 | residential care setting with      |
|                                 | medical evaluation and management  |
|                                 | services, approx. 75 to 80 min.    |
|                                 | face-to-face with the patient      |
+---------------------------------+------------------------------------+
| 90823                           | Individual psychotherapy,          |
|                                 | interactive, using play equipment, |
|                                 | physical devices, language         |
|                                 | interpreter, or other mechanisms   |
|                                 | of non-verbal communication, in an |
|                                 | inpatient hospital, partial        |
|                                 | hospital or residential care       |
|                                 | setting, approx. 20 to 30 min.     |
|                                 | face-to-face with the patient      |
+---------------------------------+------------------------------------+
| 90824                           | Individual psychotherapy,          |
|                                 | interactive, using play equipment, |
|                                 | physical devices, language         |
|                                 | interpreter, or other mechanisms   |
|                                 | of non-verbal communication, in an |
|                                 | inpatient hospital, partial        |
|                                 | hospital or residential care       |
|                                 | setting with medical evaluation    |
|                                 | and management services, approx.   |
|                                 | 20 to 30 min. face-to-face with    |
|                                 | the patient                        |
+---------------------------------+------------------------------------+
| 90826                           | Individual psychotherapy,          |
|                                 | interactive, using play equipment, |
|                                 | physical devices, language         |
|                                 | interpreter, or other mechanisms   |
|                                 | of non-verbal communication, in an |
|                                 | inpatient hospital, partial        |
|                                 | hospital or residential care       |
|                                 | setting, approx. 45 to 50 min.     |
|                                 | face-to-face with the patient      |
+---------------------------------+------------------------------------+
| 90827                           | Individual psychotherapy,          |
|                                 | interactive, using play equipment, |
|                                 | physical devices, language         |
|                                 | interpreter, or other mechanisms   |
|                                 | of non-verbal communication, in an |
|                                 | inpatient hospital, partial        |
|                                 | hospital or residential care       |
|                                 | setting with medical evaluation    |
|                                 | and management services, approx.   |
|                                 | 45 to 50 min. face-to-face with    |
|                                 | the patient                        |
+---------------------------------+------------------------------------+
| 90828                           | Individual psychotherapy,          |
|                                 | interactive, using play equipment, |
|                                 | physical devices, language         |
|                                 | interpreter, or other mechanisms   |
|                                 | of non-verbal communication, in an |
|                                 | inpatient hospital, partial        |
|                                 | hospital or residential care       |
|                                 | setting, approx. 75 to 80 min.     |
|                                 | face-to-face with the patient      |
+---------------------------------+------------------------------------+
| 90829                           | Individual psychotherapy,          |
|                                 | interactive, using play equipment, |
|                                 | physical devices, language         |
|                                 | interpreter, or other mechanisms   |
|                                 | of non-verbal communication, in an |
|                                 | inpatient hospital, partial        |
|                                 | hospital or residential care       |
|                                 | setting with medical evaluation    |
|                                 | and management services, approx.   |
|                                 | 75 to 80 min. face-to-face with    |
|                                 | the patient                        |
+---------------------------------+------------------------------------+
| 90845                           | Psychoanalysis                     |
+---------------------------------+------------------------------------+
| 90846                           | Family psychotherapy (without the  |
|                                 | patient present)                   |
+---------------------------------+------------------------------------+
| 90847                           | Family psychotherapy (conjoint     |
|                                 | psychotherapy) (with patient       |
|                                 | present)                           |
+---------------------------------+------------------------------------+
| 90849                           | Multiple-family group              |
|                                 | psychotherapy                      |
+---------------------------------+------------------------------------+
| 90853                           | Group psychotherapy (other than of |
|                                 | a multiple-family group)           |
+---------------------------------+------------------------------------+
| 90857                           | Interactive group psychotherapy    |
+---------------------------------+------------------------------------+
| 90862                           | Pharmacologic management,          |
|                                 | including prescription, use, and   |
|                                 | review of medication with no more  |
|                                 | than minimal medical psychotherapy |
+---------------------------------+------------------------------------+
| 90865                           | Narcosynthesis for psychiatric     |
|                                 | diagnostic and therapeutic         |
|                                 | purposes (e.g., sodium amobarbital |
|                                 | (amytal) interview)                |
+---------------------------------+------------------------------------+
| 90870                           | Electroconvulsive therapy          |
|                                 | (includes necessary monitoring);   |
|                                 | single seizure                     |
+---------------------------------+------------------------------------+
| 90871                           | Electroconvulsive therapy          |
|                                 | (includes necessary monitoring);   |
|                                 | multiple seizures, per day         |
+---------------------------------+------------------------------------+
| 90875                           | Individual psychophysiological     |
|                                 | therapy incorporating biofeedback  |
|                                 | training by any modality           |
|                                 | (face-to-face with the patient),   |
|                                 | with psychotherapy (e.g., insight  |
|                                 | oriented, behavior modifying or    |
|                                 | supportive psychotherapy); approx. |
|                                 | 20- 30 min.                        |
+---------------------------------+------------------------------------+
| 90876                           | Individual psychophysiological     |
|                                 | therapy incorporating biofeedback  |
|                                 | training by any modality           |
|                                 | (face-to-face with the patient),   |
|                                 | with psychotherapy (e.g., insight  |
|                                 | oriented, behavior modifying or    |
|                                 | supportive psychotherapy); approx. |
|                                 | 45- 50 min.                        |
+---------------------------------+------------------------------------+
| 90880                           | Hypnotherapy                       |
+---------------------------------+------------------------------------+
| 90882                           | Environmental intervention for     |
|                                 | medical management purposes on a   |
|                                 | psychiatric patient's behalf with  |
|                                 | agencies, employers, or            |
|                                 | institutions                       |
+---------------------------------+------------------------------------+
| 90885                           | Psychiatric evaluation of hospital |
|                                 | records, other psychiatric         |
|                                 | reports, psychometric and/or       |
|                                 | projective tests, and other        |
|                                 | accumulated data for medical       |
|                                 | diagnostic purposes                |
+---------------------------------+------------------------------------+
| 90887                           | Interpretation or explanation of   |
|                                 | results of psychiatric, other      |
|                                 | medical examinations and           |
|                                 | procedures, or other accumulated   |
|                                 | data to family or other persons,   |
|                                 | or advising them how to assist     |
|                                 | patient                            |
+---------------------------------+------------------------------------+
| 90889                           | Preparation of report of           |
|                                 | patient\'s psychiatric status,     |
|                                 | history, treatment, or progress    |
|                                 | (other than for legal or           |
|                                 | consultative purposes) for other   |
|                                 | physicians, agencies, or insurance |
|                                 | carriers                           |
+---------------------------------+------------------------------------+
| 90899                           | Unlisted psychiatric service or    |
|                                 | procedure                          |
+---------------------------------+------------------------------------+
|                                 |                                    |
+---------------------------------+------------------------------------+
| 0074T **(Temporary; Official in | #### Online consultat              |
| July 2004)**                    | ion between physician and patient  |
+---------------------------------+------------------------------------+

+---------------------------------+------------------------------------+
| **MODIFIERS**                   | # Description                      |
+---------------------------------+------------------------------------+
| ###                             |                                    |
|                                 |                                    |
| ##### C                         |                                    |
| ode Set 1: Specialized Programs |                                    |
+---------------------------------+------------------------------------+
| HA                              | Child/adolescent program           |
+---------------------------------+------------------------------------+
| ### HB                          | #### Adult program, non-geriatric  |
+---------------------------------+------------------------------------+
| ### HC                          | #                                  |
|                                 | ### Older adult program, geriatric |
+---------------------------------+------------------------------------+
| HD                              | Pregnant/parenting women's program |
+---------------------------------+------------------------------------+
| #### HE                         | #### Mental health program         |
+---------------------------------+------------------------------------+
| HF                              | Substance abuse program            |
+---------------------------------+------------------------------------+
| HG                              | Opioid addiction treatment program |
+---------------------------------+------------------------------------+
| HH                              | Integrated mental health/substance |
|                                 | abuse program                      |
+---------------------------------+------------------------------------+
| HI                              | Integrated mental health and       |
|                                 | mental                             |
|                                 | reta                               |
|                                 | rdation/developmental/disabilities |
|                                 | program                            |
+---------------------------------+------------------------------------+
| HJ                              | Employee assistance program        |
+---------------------------------+------------------------------------+
| HK                              | Specialized mental health programs |
|                                 | for high-risk populations          |
+---------------------------------+------------------------------------+

+---------------------------------+------------------------------------+
|                                 |                                    |
+---------------------------------+------------------------------------+
| *Code Set 2: Education level of |                                    |
| treatment staff*                |                                    |
+---------------------------------+------------------------------------+
| HL                              | Intern                             |
+---------------------------------+------------------------------------+
| HM                              | Less than bachelor degree level    |
+---------------------------------+------------------------------------+
| HN                              | Bachelors degree level             |
+---------------------------------+------------------------------------+
| HO                              | Masters degree level               |
+---------------------------------+------------------------------------+
| HP                              | Doctoral level                     |
+---------------------------------+------------------------------------+
| ###                             |                                    |
|                                 |                                    |
| ##                              |                                    |
| # Code Set 3: Treatment context |                                    |
+---------------------------------+------------------------------------+
| HQ                              | Group setting                      |
+---------------------------------+------------------------------------+
| HR                              | Family/couple with client present  |
+---------------------------------+------------------------------------+
| HS                              | Family/couple without client       |
|                                 | present                            |
+---------------------------------+------------------------------------+
| UK                              | Collateral                         |
+---------------------------------+------------------------------------+

+---------------------------------+------------------------------------+
|                                 |                                    |
+---------------------------------+------------------------------------+
| ###                             |                                    |
|                                 |                                    |
| ###                             |                                    |
|  Code Set 4: Multidisciplinary  |                                    |
+---------------------------------+------------------------------------+
| HT                              | Multi-disciplinary team            |
+---------------------------------+------------------------------------+
|                                 |                                    |
+---------------------------------+------------------------------------+
| *Code Set 5: Service            |                                    |
| funding/financing arrangement*  |                                    |
+---------------------------------+------------------------------------+
| HU                              | Funded by child welfare agency     |
+---------------------------------+------------------------------------+
| HV                              | Funded by state addictions agency  |
+---------------------------------+------------------------------------+
| HW                              | Funded by state mental health      |
|                                 | agency                             |
+---------------------------------+------------------------------------+
| HX                              | Funded by county/local agency      |
+---------------------------------+------------------------------------+
| HY                              | Funded by juvenile justice agency  |
+---------------------------------+------------------------------------+
| HZ                              | Funded by criminal justice agency  |
+---------------------------------+------------------------------------+
|                                 |                                    |
+---------------------------------+------------------------------------+
| ###                             |                                    |
|                                 |                                    |
| ### Code                        |                                    |
|  Set 7: Court-ordered treatment |                                    |
+---------------------------------+------------------------------------+
| H9                              | Court-ordered                      |
+---------------------------------+------------------------------------+

+---------------------------------+------------------------------------+
|                                 |                                    |
+---------------------------------+------------------------------------+
| TF                              | Intermediate level of care         |
+---------------------------------+------------------------------------+
| TG                              | Complex/high-tech level of care    |
+---------------------------------+------------------------------------+
| TN                              | Rural/out of service area          |
+---------------------------------+------------------------------------+
| TS                              | Follow-up service                  |
+---------------------------------+------------------------------------+
| U1-U9                           | Medicaid level of care #, as       |
|                                 | defined by each State              |
+---------------------------------+------------------------------------+
| UA-UD                           | Medicaid level of care #, as       |
|                                 | defined by each State              |
+---------------------------------+------------------------------------+
|                                 |                                    |
+---------------------------------+------------------------------------+
| #####                           |                                    |
|                                 |                                    |
| ##### CPT Modifiers             |                                    |
+---------------------------------+------------------------------------+
| CPT 22                          | Unusual procedural services        |
+---------------------------------+------------------------------------+
| CPT 52                          | Reduced services                   |
+---------------------------------+------------------------------------+

+---------------------------------+------------------------------------+
|                                 |                                    |
+---------------------------------+------------------------------------+
| #####                           |                                    |
|                                 |                                    |
| ##### Other Modifiers           |                                    |
+---------------------------------+------------------------------------+
| QJ                              | Services/items provided to a       |
|                                 | prisoner or patient in State or    |
|                                 | local custody, however the State   |
|                                 | or local government, as            |
|                                 | applicable, meets the requirements |
|                                 | in 42 CFR 411.4 (B)                |
+---------------------------------+------------------------------------+
| TJ                              | Program group, child and/or        |
|                                 | adolescent                         |
+---------------------------------+------------------------------------+

[^1]: Special thanks for work on the HCPCS codes go to Vijay Ganju of
    the National Association of State Mental Health Program Directors;
    Kathleen Nardini of the National Association of State Alcohol and
    Drug Abuse Directors, Inc.; and the committee of representatives
    from the State mental health and substance abuse agencies who worked
    with those organizations, with additional thanks to Ron Tremper of
    the Rhode Island Department of Mental Health, Retardation, and
    Hospitals.

    The development of this document was funded by the Center for
    Substance Abuse Treatment (CSAT) in connection with CSAT\'s \"State
    Health Care Reform Technical Assistance, and Knowledge Synthesis and
    Dissemination Project\" (Contract No. 270-00-7071), which is managed
    by Health Systems Research, Inc.

    Current Procedural Terminology (CPT) used herein is copyright 2003
    American Medical Association.

    ^?^ For purposes of this table, the term "Behavioral Health" refers
    to substance abuse treatment and mental health, and does not refer
    to services to persons with developmental disabilities.