H2036 Code Description: SUD Treatment Program Per Diem (Residential)
H2036 is the per diem many states use for SUD residential and program-based care. Ohio's manual shows how a state maps it to ASAM levels.
Short answer
H2036 is "Alcohol and/or other drug treatment program, per diem." Ohio bills it for SUD residential care: ASAM 3.3 for adults, with HI, the modifier Ohio defines as cognitive impairment for that level, and ASAM 3.5, clinically managed high intensity, each at $240.95 per diem in place of service 55, rendered by an independently licensed practitioner with an SUD scope. Ohio allows up to 30 consecutive days of SUD residential care without prior authorization.
| Code | HCPCS descriptor | Unit |
|---|---|---|
| H2036 | Alcohol and/or other drug treatment program, per diem | Day |
Ohio: residential by ASAM level
| ASAM level (Ohio) | Code and modifier | Ohio rate | Place of service |
|---|---|---|---|
| 3.3 (adults; HI marks cognitive impairment) | H2036 HI | $240.95 per diem | 55 |
| 3.5, clinically managed high intensity | H2036 | $240.95 per diem | 55 |
Rendered by any independently licensed practitioner with an SUD scope of practice. SUD residential (H2034, H2036): up to 30 consecutive days without prior authorization.
Colorado: one code, four ASAM levels
| ASAM level (Colorado) | Code and first-position modifier |
|---|---|
| 3.1 Clinically managed low-intensity residential | H2036 U1 |
| 3.3 Clinically managed population-specific high-intensity residential (18+) | H2036 U3 |
| 3.5 Clinically managed high-intensity residential | H2036 U5 |
| 3.7 Medically monitored intensive inpatient | H2036 U7 |
Colorado SBHS Billing Manual, August 2026. Place of service 55. MAT and medication management bill separately, room and board bills to BHA on S9976, and withdrawal management is included for members under 18.
Common H2036 denials
- Past 30 days without authorization. Ohio needs prior authorization beyond 30 consecutive days.
- Level and modifier mismatch. The ASAM level modifier missing or wrong: Ohio's HI for 3.3, or Colorado's U1, U3, U5, or U7.
- Wrong place of service. Residential per diems outside POS 55.
Related: H0015 intensive outpatient, IOP and PHP billing, and H codes in behavioral health.
Sources, read October 2026: Ohio Medicaid Behavioral Health Provider Manual, v1.28.1 (March 2026); Colorado State Behavioral Health Services Billing Manual (August 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 H2036 code description?
H2036 is "Alcohol and/or other drug treatment program, per diem."
How does Ohio bill SUD residential treatment?
As H2036 per diem: ASAM 3.3 with the HI modifier and ASAM 3.5 without, each $240.95 in place of service 55, as of the March 2026 manual.
How does Colorado bill ASAM levels on H2036?
With a first-position modifier for the level: U1 for 3.1, U3 for 3.3, U5 for 3.5, and U7 for 3.7, in place of service 55.
Does SUD residential need prior authorization in Ohio?
After 30 consecutive days. Ohio allows up to 30 consecutive days of SUD residential care without prior authorization.
Residential days counted, authorizations on time.
See Stable track consecutive residential days and flag authorizations before day 30.
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