Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
1
Revised 10/3/2013
90832 Psychotherapy, 30 minutes with patient and/or family member
0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 90833
Psychotherapy, 30 minutes with patient and/or family member when performed with an evaluation and management service (list separately in addition to the code for primary procedure)
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
2
Revised 10/3/2013
90834 Psychotherapy, 45 minutes with patient and/or family member
0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 90836
Psychotherapy, 45 minutes with patient and/or family memberwhen performed with an evaluation and management service (list separately in addition to the code for primary procedure)
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
3
Revised 10/3/2013
90837 Psychotherapy, 60 minutes with patient and/or family member
0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 90838
Psychotherapy, 60 minutes with patient and/or family member when performed with an evaluation and management service (list separately in addition to the code for primary procedure)
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
4
Revised 10/3/2013
90875 Interactive complexity (list separately in addition to the code for primary procedure 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
5
Revised 10/3/2013
99201
Office or other outpatient visit for the evaluation and management of new patient, which requires these 3 key components: a problem-focused history; a problem-focused examination; and, straightforward
medical decision-making. (Approx 10 min)
0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99202
Office or other outpatient visit for the evaluation and management of new patient, which requires these 3 key components: expanded problem-focused history; an expanded problem-focused exam; and straightforward medical decision-making. (Approx 20 min)
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
6
Revised 10/3/2013
99203
Office or other outpatient visit for the evaluation and management of new patient, which requires these 3 key components: a detailed history; a detailed examination; and, medical decision-making of low complexity. (Approx 30 min)
0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99204
Office or other outpatient visit for the evaluation and management of new patient, which requires these 3 key components: a
comprehensive history; a comprehensive examination; and, medical decision-making of moderate complexity. (Approx 45 min)
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
7
Revised 10/3/2013
99205
Office or other outpatient visit for the evaluation and management of new patient, which requires these 3 key components: a
comprehensive history; a comprehensive examination; and, medical decision-making of high complexity. (Approx 60 min)
0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99211
Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician. Usually, the presenting problems are minimal. Typically, 5 minutes are spent performing or supervising these services.
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
8
Revised 10/3/2013
99212
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: a problem-focused history; a problem-focused examination; straightforward medical decision-making. (Approx 10 min) 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99213
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: an expanded problem-focused history; an expanded problem-focused examination; medical decision-making of low complexity. (Approx 15 min)
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
9
Revised 10/3/2013
99214
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: a detailed history; a detailed examination; medical decision-making of moderate complexity. (Approx 25 min)
0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99215
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: a comprehensive history; a comprehensive examination; and medical decision-making of high complexity. (Approx 40 min)
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
10
Revised 10/3/2013
99217 Observation care discharge day management.
0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99218
Initial observation care, per day, for the evaluation and management of a patient which requires the three key components: a detailed or comprehensive history; a detailed or comprehensive examination; and medical decision making that is straightforward or of low complexity.
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
11
Revised 10/3/2013
99219
Initial observation care, per day, for the evaluation and management of a patient, which requires these three key components: a
comprehensive history; a comprehensive examination; and medical decision making of moderate complexity.
0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99220
Initial observation care, per day, for the evaluation and management of a patient, which requires these three key components: a
comprehensive history; a comprehensive examination; and medical decision making of high complexity.
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
12
Revised 10/3/2013
99241
Office consultation for a new or established patient, which requires these 3 key components: a problem-focused history; a problem-focused examination; and medical decision-making for a minor presenting problem. (Approx. 15 minutes) 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99242
Office consultation for a new or established patient, which requires these 3 key components: an expanded problem-focused history; an expanded problem-focused examination; and straightforward medical decision-making for problems of a low severity. (Approx. 30 minutes)
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
13
Revised 10/3/2013
99243
Office consultation for a new or established patient, which requires these 3 key components: a detailed history; a detailed examination; and medical decision-making for a problem of low complexity. (Approx. 40 minutes)
0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99244
Office consultation for a new or established patient, which requires these 3 key components: a comprehensive history; a comprehensive examination; and medical decision-making of moderate complexity for problems of a moderate/high severity. (Approx. 60 minutes)
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
14
Revised 10/3/2013
99245
Office consultation for a new or established patient, which requires these 3 key components: a comprehensive history; a comprehensive examination; and medical decision-making for a problem of a high severity. (Approx. 80 minutes) 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99281
Emergency department visit for the evaluation and management of a patient, which requires these three key components: a problem-focused history; a problem-focused examination; and straightforward
medical decision-making. Presenting problem(s) are self-limited or minor. 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
15
Revised 10/3/2013
99282
Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: an expanded problem-focused history; an expanded problem-focused examination; and medical decision-making for a problem of low complexity. Presenting problem(s) are of low to moderate severity.
0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99283
Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: an expanded problem-focused history; an expanded problem-focused examination; and medical decision-making for a problem of moderate complexity. Presenting problem(s) are of moderate severity.
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
16
Revised 10/3/2013
99284
Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: a detailed history; a detailed examination; and medical decision-making of moderate complexity. Presenting problem(s) are of high severity.
0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99285
Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: a comprehensive history; a comprehensive examination; and medical decision- making of high complexity. Presenting problem(s) are of high severity.
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
17
Revised 10/3/2013
99301
Evaluation and management of a new or established patient involving an annual nursing facility assessment which requires these 3 components: a detailed interval history; a comprehensive
examination; and medical decision making that is straightforward or of low complexity. (Approx. 30 minutes)
0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99302
Evaluation and management of a new or established patient involving a nursing facility assessment which requires these 3 components: a detailed interval history; a comprehensive examination; and medical decision making of moderate to high complexity. (Approx. 40 minutes) 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
18
Revised 10/3/2013
99303
Evaluation and management of a new or established patient involving a nursing facility assessment at the time of initial admission or readmission to the facility, which requires these three components: a comprehensive history; a comprehensive examination; and medical decision making of moderate to high complexity. (Approx. 50 minutes) 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99304
Initial nursing facility care, per day, for the evaluation and management of a patient which requires these three key components: a detailed or
comprehensive history; a detailed or comprehensive examination; and medical decision making that is straightforward or of low complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem and the patient's and/or family's needs. Usually the problem(s) requiring admission are of low severity 99318 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
19
Revised 10/3/2013
99305
Initial nursing facility care, per day, for the evaluation and management of a patient which requires these three key components: a comprehensive history; a comprehensive examination; and medical decision making of moderate complexity. Usually, the problem(s) requiring admission are of moderate severity. 99318 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99306
Initial nursing facility care, per day, for the evaluation and management of a patient which requires these three key components: a comprehensive history; a comprehensive examination; and medical decision making of high
complexity. Usually, the problem(s) requiring admission are of high severity
99318 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
20
Revised 10/3/2013
99307
Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least two of these three key components: a problem focused interval history; a problem focused examination; straightforward medical decision making. Usually the patient is stable, recovering, or improving. 99318 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99308
Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least two of these three key components: an expanded problem focused interval history; an expanded problem focused examination; medical decision making of low complexity. Usually, the patient is responding inadequately to therapy or has developed a minor complication.
99318 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
21
Revised 10/3/2013
99309
Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least two of these three key components: a detailed interval history; a detailed examination; medical decision making of moderate complexity. Usually, the patient has developed a significant complication or a significant new problem.
99318 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99310
Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least two of these three key components: a comprehensive interval history; a comprehensive examination; medical decision making of high complexity. The patient may be unstable or may have developed a significant new problem requiring immediate physician attention. 99318 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
22
Revised 10/3/2013
99315 Nursing facility discharge day management, 30 minutes or less 99318
0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
99316 Nursing facility discharge day management, more than 30 minutes. 99318
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
23
Revised 10/3/2013
99318
Evaluation and management of a patient involving an annual nursing facility assessment, which requires these three key components: a detailed interval history; a comprehensive examination; and medical decision making that is of low to moderate complexity. Usually, the patient is stable, recovering, or improving. 99304, 99305, 99306, 99307, 99308, 99309, 99310,99315, 99316 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99321
Domiciliary or rest home visit for the evaluation and management of a new patient which requires these 3 key components: a problem-focused history; a problem-focused examination; and, medical decision-making for a problem of low severity. (Approx 20 minutes)
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
24
Revised 10/3/2013
99322
Domiciliary or rest home visit for the evaluation and management of a new patient which requires these 3 key components: an expanded problem-focused history; an expanded problem-problem-focused examination; and, medical decision-making for a moderately severe problem.
0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99323
Domiciliary or rest home visit for the evaluation and management of a new patient which requires these 3 key components: a detailed history; a detailed examination; and, medical decision-making for a problem of high severity. (Approx. 50 minutes) 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
25
Revised 10/3/2013
99324
Domiciliary or rest home visit for the evaluation and management of a new patient, which requires these three key components: a problem focused history; a problem focused examination; and straightforward medical decision making. Usually, the presenting problem(s) are of low severity. Physicians typically spend 20 minutes with the patient an/or family or caregiver.
0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99325
Domiciliary or rest home visit for the evaluation and management of a new patient, which requires these three key components: an expanded problem focused history; an expanded problem focused examination; and medical decision making of low complexity. Usually, the presenting problem(s) are of moderate severity. Physicians typically spend 30 minutes with the patient and/or family or caregiver.
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
26
Revised 10/3/2013
99326
Domiciliary or rest home visit for the evaluation and management of a new patient, which requires these three key components: a detailed history; a detailed examination; and medical decision making of moderate complexity. Usually, the presenting problem(s) are of moderate to high severity. Physicians typically spend 45 minutes with the patient and/or family or caregiver. 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99327
Domiciliary or rest home visit for the evaluation and management of a new patient, which requires these three key components: a comprehensive history; a comprehensive examination; and medical decision making of moderate complexity. Usually, the presenting problem(s) are of high severity. Physicians typically spend 60 minutes with the patient and/or family or caregiver. 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
27
Revised 10/3/2013
99328
Domiciliary or rest home visit for the evaluation and management of a new patient, which requires these three key components: a comprehensive history; a comprehensive examination; and medical decision making of high complexity. Usually, the patient is unstable or has developed a significant new problem requiring immediate physician attention. Physicians typically spend 75 minutes with the patient and/or family or caregiver.
0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99331
Domiciliary or rest home visit for the evaluation and management of an established patient which requires at least 2 of these 3 key components: a problem-focused interval history; a problem-focused examination; and, medical decision-making for a patient who is stable or improving. (Approx. 15 minutes) 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
28
Revised 10/3/2013
99332
Domiciliary or rest home visit for the evaluation and management of an established patient which requires at least 2 of these 3 key components: an expanded problem-focused interval history; an expanded problem-focused examination; and, decision-making for a patient who is responding inadequately or for a minor complication. (Approx. 25 minutes)
0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99333
Domiciliary or rest home visit for the evaluation and management of an established patient which requires at least 2 of these 3 key components: a detailed interval history; a detailed examination; and, decision-making regarding unstable patient/significant complication/new problem. (Approx. 35 minutes) 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
29
Revised 10/3/2013
99334
Domiciliary or rest home visit for the evaluation and management of an established patient, which requires at least two of these three key components: a problem focused interval history; a problem focused examination; straightforward medical decision making. Usually, the
presenting problem(s) are self-limited or minor. Physicians typically spend 15 minutes with the patient and/or family or caregiver.
0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99335
Domiciliary or rest home visit for the evaluation and management of an established patient, which requires at least two of these three key components: an expanded problem focused interval history; an expanded problem focused examination; medical decision making of low complexity. Usually, the presenting problem(s) are of low to moderate severity. Physicians typically spend 25 minutes with the patient and/or family or caregiver. 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
30
Revised 10/3/2013
99336
Domiciliary or rest home visit for the evaluation and management of an established patient, which requires at least two of these three key components: a detailed interval history; a detailed examination; medical decision making of moderate complexity. Usually, the presenting problem(s) are of moderate to high severity. Physicians typically spend 40 minutes with the patient and/or family or caregiver.
0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99337
Domiciliary or rest home visit for the evaluation and management of an established patient, which requires at least two of these three key components: a comprehensive interval history; a comprehensive
examination; and medical decision making of moderate to high complexity. Usually, the presenting problem(s) are of moderate to high severity. The patient may be unstable or may have developed a significant new problem requiring immediate physician attention. Physicians typically spend 60 minutes with the patient and/or family or caregiver.
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
31
Revised 10/3/2013
99341
Home visit for the evaluation and management of a new patient which requires these 3 key components: a problem-focused history; a problem focused examination; and medical decision-making for a low severity problem. (Approx. 20 minutes)
0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99342
Home visit for the evaluation and management of a new patient which requires 3 key components: an expanded problem-focused history; and expanded problem-focused examination; and medical decision-making for a moderately severe problem. (Approx. 35 minutes)
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
32
Revised 10/3/2013
99343
Home visit for the evaluation and management of a new patient which requires 3 key components: a detailed history; a detailed examination; and decision-making for a highly severe problem. (Approx. 45 minutes)
0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99344
Home visit for the evaluation and management of a new patient, which requires these three components: a comprehensive history; a comprehensive examination; and medical decision-making of moderate complexity. (Approx 60 min)
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
33
Revised 10/3/2013
99345
Home visit for the evaluation and management of a new patient, which requires these three components: a comprehensive history; a comprehensive examination; and medical decision-making of high complexity. (Approx 75 min)
0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99347
Home visit for the evaluation and management of an established patient, which requires at least two of these three key components: a problem focused interval history; a problem-focused examination; straightforward medical decision-making. (Approx 15 min)
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
34
Revised 10/3/2013
99348
Home visit for the evaluation and management of an established patient, which requires at least two of these three key components: an expanded problem focused interval history; an expanded problem focused examination; medical decision-making of low complexity. (Approx 25 min) 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99349
Home visit for the evaluation and management of an established patient, which requires at least two of these three key components: a detailed interval history; a detailed examination; medical decision-making of moderate complexity. (Approx 40 min)
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
35
Revised 10/3/2013
99350
Home visit for the evaluation and management of an established patient, which requires at least two of these three key components: a comprehensive interval history; a comprehensive examination; medical decision-making of moderate to high complexity. (Approx 60 min) 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 99354
Prolonged physician service in the office or other outpatient setting requiring direct (face-to-face) patient contact beyond the usual service (e.g., prolonged care and treatment of an acute asthmatic patient in an outpatient setting); first hour. (List separately in addition to code for office or other outpatient evaluation and management service)
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
36
Revised 10/3/2013
99355
Prolonged physician service in the office or other outpatient setting requiring direct (face-to-face) patient contact beyond the usual service (e.g., prolonged care and treatment of an acute asthmatic patient in an outpatient setting). [Use for each additional 30 min in conjunction with 99354] 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
H0001 Alcohol and/or drug assessment H0018
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
37
Revised 10/3/2013
H0002 Behavioral health screening to determine eligibility for admission H0018
0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
H0031 Mental health assessment / by Non-Physician H0018
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
38
Revised 10/3/2013
H0004 Office, individual behavioral health counseling and therapy, per 15 minutes
0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
H0004 Home, individual behavioral health counseling and therapy, per 15 minutes
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
39
Revised 10/3/2013
H0004 Office, family behavioral health counseling and therapy with client present per
15 minutes HR 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
H0004 Office, family behavioral health counseling and therapy without client present
per 15 minutes HS 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
40
Revised 10/3/2013
H0004 Out of office, family behavioral health counseling and therapy with client
present per 15 minutes HR
0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
H0004 Out of office, family behavioral health counseling and therapy without client
present per 15 minutes HS
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
41
Revised 10/3/2013
H0015
Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is bassed on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education
H2033 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
H2033 Multisystemic therapy for juveniles, per 15 minutes H0015
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 Rehabilitation Services
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
42
Revised 10/3/2013
H2014 * Individual skills training and development, per 15 minutes
H2017, H0018, S5109HB, S5109HC, S5109HA 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
H2014 * Group skills training and development, per 15 minutes per person HQ
H2017, H0018,, S5109HB, S5109HC, S5109HA 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
43
Revised 10/3/2013
H2017 * Psychosocial rehabilitation living skills training services, per 15 minutes
H2014, H2014HQ, H0018, S5109HB, S5109HC, S5109HA 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
H0025 Behavioral health prevention/promotion education service (services to target
population to affect knowledge, attitude and/or behavior) H0018
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
44
Revised 10/3/2013
H0034 Medication training and support H0018
0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
H2025 Ongoing support to maintain employment, per 15 minutes H2026, H2027
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
45
Revised 10/3/2013
H2026 Ongoing support to maintain employment, per diem H2025, H2027
0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
H2027 Psychoeducational service (pre-job training and development), per 15
minutes H2025, H2026 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
46
Revised 10/3/2013
T1002 RN services, up to 15 minutes 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 T1003 LPN services, up to 15 minutes 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 Support Services
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
47
Revised 10/3/2013
T1013 Sign language or oral interpretive services
0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
T1019 * Personal care service, per 15 minutes, not for inpatient or residential care facilities S5109HB, S5109HC, S5109HA, H0018, T1020 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
48
Revised 10/3/2013
T1020 Personal care services, per diem, not for an inpatient or residential care facilities S5109HB, S5109HC, S5109HA, H0018, T1019, S5151 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
S5110 * Home care training, family; per 15 minutes
S5109HB, S5109HC, S5109HA H0038 Self-help/peer services, per 15 minutes H2016 H2016 Comprehensive community support services, per diem H0038, H0038 HQ H0038 Self-help/peer services group, per 15 minutes HQ H2016
S5109HB Home care training to home care client, per session (adult)
S5109HC, S5109HA, T1019, T1020, H0018, H2014, H2014HQ, H2017,S5110, S5151 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
49
Revised 10/3/2013
S5109HC Home care training to home care client, per session (adult geriatric)
S5109HB, S5109HA, T1019, T1020, H0018, H2014, H2014HQ, H2017,S5110, S5151 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
S5109HA Home care training to home care client, per session (child)
S5109HB, S5109HC, T1019, T1020, H0018, H2014, H2014HQ, H2017, S5110, S5151 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
50
Revised 10/3/2013
S5150 Unskilled respite care, not hospice; per 15 minutes H0018, S5151
0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
S5151 Unskilled respite care, not hospice; per diem
H0018, S5109HB, S5109HC, S5150, S5109HA 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
51
Revised 10/3/2013
S9484 Crisis intervention mental health service, per hour S9485
0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
S9485 Crisis intervention mental health service, per diem H0018, S9484
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
52
Revised 10/3/2013
H2011 Crisis intervention service, per 15 minutes
0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
H2011 Crisis intervention service via 2 person team, per 15 minutes HT
0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
53
Revised 10/3/2013
H2012 Supervised behavioral health day treatment, per hour
H0018, H2015, H2019, H2019TF, H2020, H0036, H0036TF, H0037 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
H2015 Comprehensive community support services, supervised day program, per 15 minutes H0018, H2012, H2019, H2019TF, H2020, H0036, H0036TF, H0037 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
54
Revised 10/3/2013
H2019 Therapeutic behavioral services day program, per 15 minutes
H0018, H2012, H2015, H2019TF, H2020, H0036, H0036TF, H0037 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
H2019 Therapeutic behavioral services day program, per 15 minutes (min. of 3 hours
and less than 6 hours) TF
H0018, H2012, H2015, H2019, H2020, H0036, H0036TF, H0037 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
55
Revised 10/3/2013
H2020 Therapeutic behavioral services, per diem
H0018, H2012, H2015, H2019, H2019TF, H0036, H0037, H0036TF 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
H0036 Community psychiatric supportive treatment day program, face-to-face, per 15 minutes H0018, H2012, H2015, H2019, H2019TF, H2020, H0036TF, H0037, 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
56
Revised 10/3/2013
H0036 Community psychiatric supportive treatment medical day program,
face-to-face, per 15 minutes TF
H0018, H2012, H2015, H2019, H2019TF, H2020, H0036, H0037, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
H0037 Community psychiatric supportive treatment medical day program, per diem
H0018, H2012, H2015, H2019, H2019TF, H2020, H0036, H0036TF 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
57
Revised 10/3/2013
H2019 Home therapeutic behavioral services day program, per 15 minutes TF
H0018, H2012, H2015, H2019, H2020, H0036, H0036TF, H0037 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
H2020 Home therapeutic behavioral health day services, per diem
H0018, H2012, H2015, H2019, H2019TF, H0036, H0036TF, H0037 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
58
Revised 10/3/2013
H0036 Home community psychiatric supportive medical treatment, face-to-face, per 15 minutes H0018, H2012, H2015, H2019, H2019TF, H2020, H0036TF, H0037 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
H0036 Home community psychiatric supportive medical treatment, face-to-face, per
15 minutes TF H0018, H2012, H2015, H2019, H2019TF, H2020, H0036, H0037 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
59
Revised 10/3/2013
H0037 Home community psychiatric supportive medical treatment program, per diem H0018, H2012, H2015, H2019, H2019TF, H2020, H0036, H0036TF 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 H0043 Supported Housing H0018 0114, 0124, 0134, 0154, 0116, 0126, 0136, 0156, 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210 Residential Services
Billing limitations do not apply to admit or discharge dates of service.
* Indicates service may be allowable in addition to HCTC if billed with an override and documented in the Client's medical record
60
Revised 10/3/2013
H0018 Behavioral health; short-term residential, without room and board
H0034, H0037, H0043, H2012, H2014, H2014HQ, H2015, H2017, H2019, T1019, T1020, S5109HB, S5109HC, S5109HA, S5150, S5151, H2019TF, H2020, H0036, H0036TF, S9485 0110, 0111, 0112, 0113, 0120, 0121, 0122, 0123, 0130, 0131, 0132, 0133, 0150, 0151, 0152, 0153, 0160, 0200, 0201, 0202, 0203, 0206, 0209, 0210
