H2012 Code Description: Behavioral Health Day Treatment Billing
H2012 pays for structured day treatment by the hour, and its main rule is knowing when an hourly day becomes a per diem.
Short answer
H2012 is "Behavioral health day treatment, per hour." Ohio bills therapeutic behavioral services day treatment as H2012 for up to two hourly units a day (0 to 2.5 hours) and switches to H2020 per diem for more than 2.5 hours. Texas lists H2012 as its Day Program for Acute Needs under mental health rehabilitation, limited to specified diagnosis codes. Ambetter stops covering H2012 on January 1, 2027.
| Code | HCPCS descriptor | Unit |
|---|---|---|
| H2012 | Behavioral health day treatment, per hour | Hour |
Ohio: hourly versus per diem
| Time in day treatment | Ohio code |
|---|---|
| 0 to 2.5 hours | H2012, hourly, maximum of 2 per day |
| Over 2.5 hours | H2020, per diem, 1 per day |
Permitted places of service 03, 04, 11, 14, 53; telehealth with GT. A second H2020 per diem the same day from a different agency needs prior authorization.
Texas: Day Program for Acute Needs
Texas Medicaid lists H2012 as the Day Program for Acute Needs within mental health rehabilitative services, and limits reimbursement for H2012, H0034, H2014, and H2017 to a specified list of diagnosis codes.
A 2027 payer change to watch
Ambetter Health has announced that it will stop covering a long list of H codes beginning January 1, 2027, including H2012. That is one payer's commercial policy, posted in several states, not a national code deletion. See Ambetter's notice and the full 48-code list and how to prepare, and confirm with any commercial plan before assuming an H code is billable there.
Common H2012 denials
- Over the daily cap. More hourly units than the state allows instead of the per diem.
- Diagnosis not on the list. Texas limits H2012 to specified diagnoses.
- Same-day per diem conflict. Hourly H2012 and per diem H2020 for the same day.
See H2019 and H2020 and H codes in behavioral health.
Sources, read October 2026: Ohio Medicaid Behavioral Health Provider Manual, v1.28.1 (March 2026); Texas Medicaid Behavioral Health and Case Management Services Handbook (January 2026). Federal HCPCS descriptors are CMS public data. Rates and rules are the state's as published on that date; confirm the current edition and your plan contract before billing.
Frequently asked questions
What is the H2012 code description?
H2012 is "Behavioral health day treatment, per hour."
When does Ohio use H2020 instead of H2012?
When day treatment runs more than 2.5 hours. Up to 2.5 hours is billed as H2012, at most 2 hourly units a day.
Is H2012 covered by Ambetter in 2027?
No. H2012 is on Ambetter's list of H codes it stops covering on January 1, 2027.
Hourly or per diem, decided before the claim.
See Stable apply each state's day treatment unit rules to H2012 and H2020.
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