H Codes in Behavioral Health: The Medicaid Code Set, Explained
If your practice bills Medicaid or works with community behavioral health programs, a second code set sits alongside CPT: the HCPCS Level II H codes. They cover services CPT doesn't — peer support, skills training, psychosocial rehab — and they're billed in 15-minute units with rules that change at every state line. Here's the map.
What H codes are (and why they exist)
H codes are HCPCS Level II codes used primarily by state Medicaid programs for behavioral health and substance use services that have no CPT equivalent — the rehabilitative, community-based services at the heart of public behavioral health. Commercial payers mostly ignore them; Medicaid managed care plans live on them. Critically, each state defines its own H-code rules: what each code means locally, which staff credentials can deliver it, unit limits, and rates. See our Medicaid behavioral health billing guide and state guides for California, Texas, New York, Florida, and Ohio.
The H codes you'll meet most often
| Code | Service (federal descriptor) | Typical unit |
|---|---|---|
| H0031 | Mental health assessment, by non-physician | Per encounter (state-defined) |
| H0038 | Self-help/peer services (peer support specialist) | Per 15 minutes |
| H2014 | Skills training and development | Per 15 minutes |
| H2011 | Crisis intervention service | Per 15 minutes |
| H0004 | Behavioral health counseling and therapy | Per 15 minutes |
| H0001 | Alcohol and/or drug assessment | Per encounter |
| H0015 | Alcohol/drug intensive outpatient (IOP) | Per diem |
| H0035 | Mental health partial hospitalization (<24 hours) | Per diem |
| H2019 | Therapeutic behavioral services | Per 15 minutes |
Federal descriptors only — your state's Medicaid manual defines what each code actually requires and pays locally.
Three codes, closer up
H0031 is the Medicaid intake for non-physician assessors in many states — where a commercial payer would expect 90791. Some states use both, split by program type; billing the wrong one is a routine denial. H0038 pays for certified peer support specialists — lived-experience staff — in 15-minute units, with state certification of the peer and often a supervising clinician required. H2014 covers skills training (daily living, social, coping skills), usually delivered by paraprofessionals under a treatment plan, also in 15-minute units.
Unit billing: where the denials live
- Round correctly. States set minimum minutes per unit (a common rule: at least 8 minutes to bill one 15-minute unit) — and they audit it.
- Daily caps. Most H codes carry per-day or per-week unit maximums; exceeding them denies the overage.
- Credential match. Each code specifies who may deliver it in your state — a service delivered by the wrong credential level is unbillable, not just discounted.
- Documentation per unit block. Notes must support the units billed: time in/out, service content, and connection to the treatment plan.
- Prior authorization. Many rehabilitative H-code services require authorization and periodic treatment-plan review to keep billing.
H-code billing is high-volume, low-dollar, rule-dense work — exactly the profile where AI billing outperforms manual processes, and where SUD billing software earns its keep for H0001/H0015 programs.
This guide is for general reference only. CPT codes, HCPCS codes, and payer rules change, always verify against current coding guidance and your specific payer policies. CPT is a registered trademark of the American Medical Association.
Code-by-code guides
- H0001 and H0002: SUD Assessment and Admission Screening Codes
- H0004 and H0005: Behavioral Health Counseling Codes, Individual and Group
- H0015 Code Description: Substance Use Intensive Outpatient (IOP)
- H0031 and H0032 Code Descriptions: MH Assessment and Service Plan
- H0036 and H2015: Community Psychiatric Support Billing
- H0038: Peer Support Services Billing Guidelines
- H2011: Crisis Intervention Service Billing
- H2014 and H2017 Code Descriptions: Skills Training and Psychosocial Rehab
- H2019 and H2020 Code Descriptions: Therapeutic Behavioral Services
- HO, HN, HP, HA, HH, AH & AJ Modifiers: Behavioral Health Descriptions
More code guides
- H0020 Code Description: Methadone Administration (OTP) Billing
- H0039 and H0040 Code Descriptions: Assertive Community Treatment (ACT)
- H2012 Code Description: Behavioral Health Day Treatment Billing
- H2036 Code Description: SUD Treatment Program Per Diem (Residential)
- H0006 Code Description: Alcohol and Drug Case Management
Frequently asked questions
What is the H0031 code?
H0031 is the HCPCS code for a mental health assessment performed by a non-physician. Many state Medicaid programs use it as the intake/assessment code for community behavioral health, where commercial payers would expect CPT 90791. Each state defines its own requirements and rate.
What are the billing guidelines for H0038?
H0038 covers self-help/peer support services delivered by a certified peer support specialist, billed in 15-minute units. States typically require peer certification, supervision by a qualified clinician, a treatment plan the service supports, and per-day unit caps — all defined in the state Medicaid manual.
What is the H2014 code?
H2014 is skills training and development — teaching daily living, social, and coping skills — billed per 15 minutes. It's typically delivered by trained paraprofessionals under an approved treatment plan in Medicaid rehabilitative services programs.
Do commercial insurance plans pay H codes?
Rarely. H codes are HCPCS Level II codes used almost entirely by state Medicaid programs and Medicaid managed care plans. Commercial payers generally expect CPT codes for comparable services.
Medicaid billing without the manual-reading.
Stable applies state-specific H-code rules — units, credentials, caps — before claims go out.
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