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Ambetter Health Billing Code Update for various HCPC H Codes: Effective 01/01/2027

Date: 06/17/26

The H codes outlined below will no longer be covered by Ambetter beginning on 01/01/2027.

 

CodeDescription (Code Name)

H0003

Alcohol/drug screening; laboratory analysis of specimens for presence of alcohol and/or drugs

H0004

Behavioral health counseling/therapy (individual)

H0005

Behavioral health counseling/therapy (group)

H0007

Alcohol/drug treatment program (intensive outpatient) -Alcohol and/or drug services; crisis intervention (outpatient)

H0008

Alcohol/drug treatment program (sub-acute detox-inpatient

H0009

Alcohol/drug treatment program (acute detox-inpatient)

H0010

Alcohol/drug treatment, sub-acute detox-residential

H0011

Alcohol/drug treatment, acute detox-residential

H0012

Alcohol/drug treatment, intermediate residential (subacute detox-residential outpatient)

H0013

Alcohol/drug treatment, extended residential-(acute detox-residential outpatient)

H0014

Alcohol/drug ambulatory detox

H0016

Alcohol/drug medical intervention in ambulatory setting

H0019

Behavioral health long-term residential care

H0021

Alcohol/drug training service (for staff & personnel not employed by providers)

H0024

Behavioral health prevention information dissemination service

H0026

Alcohol/drug prevention process service, community-based

H0027

Alcohol/drug prevention environmental service

H0028

Alcohol/drug prevention problem identification and referral service

H0029

Alcohol/drug prevention problem identification and referral service

H0030

Behavioral health hotline service

H0034

Medication training/support services, per 15 minutes

H0037

Community psychiatric support/treatment, per diem

H0039

Assertive community treatment (ACT)-per diem

H0040

ACT program, per diem

H0041

Foster care treatment services, per diem

H0042

Foster care treatment services, per month

H0043

Supported housing services, per diem

H0044

Supported housing services, per month

H0045

Respite care, not in the home, per diem

H0046

Mental health peer services-Mental health services, not otherwise specified

H0047

Alcohol/drug crisis intervention-Alcohol/drug abuse services, not otherwise specified

H1011

Family training/counseling for child development -Family assessment by licensed behavioral health professional for state defined purposes

H2001

Rehabilitation program, per 1/2 day, restore the patient’s functional abilities and return the patient to good health or a normal life through therapy and or training.

H2010

Comprehensive medication services, per 15 min

H2011

Crisis intervention, per 15 min

H2012

Behavioral health day treatment, per hour

H2013

Psychiatric health facility services, per diem

H2015

Community support services, per 15 min

H2016

 Comprehensive community support services, per diem

H2018

 Psychosocial rehabilitation services, per diem

H2021

 Community-based wrap-around services, per 15 minutes

H2022

 Community-based wrap-around services, per diem

H2028

 Sexual offender treatment service, per 15 minutes

H2029

Sexual offender treatment service, per 15 diem

H2030

Mental health clubhouse services, per 15 minutes

H2031

Mental health clubhouse services, per diem

H2032

Activity therapy, per 15 minutes

H2033

Multisystemic therapy for juveniles, per 15 minutes


The H code below will be covered by Ambetter beginning on 01/01/2027.

Code

Description

H0006

Alcohol and/or drug service, case management


If you have questions about this bulletin or other provider resources, please contact your Provider Engagement Account Manager.