H0031 and H0032: Mental Health Assessment and Service Plan Codes
H0031 and H0032 are the bookends of a community mental health intake: the assessment, and the service plan that comes out of it. Many Medicaid programs require them in place of CPT codes for non-physician staff, and many deny them when the plan and the services billed against it do not line up.
Short answer
H0031 is "Mental health assessment, by non-physician." H0032 is "Mental health service plan development by non-physician." Neither descriptor sets a unit, so the state defines it, along with who may perform each. Many states use H0031 as the community mental health intake where a commercial payer would expect 90791, and H0032 for the treatment plan that rehabilitative services are billed against.
What each code covers
| Code | Federal descriptor | Unit |
|---|---|---|
| H0031 | Mental health assessment, by non-physician | State-defined |
| H0032 | Mental health service plan development by non-physician | State-defined |
H0031 or 90791?
Both are intake assessments. The difference is the payer and the program. Commercial plans generally expect 90791 from licensed clinicians. Medicaid programs often require H0031 in community mental health and rehabilitative programs, and some use both, split by program type or credential. Billing the one your state does not expect for that program is a routine denial.
Why H0032 matters more than its rate
The service plan is the document that authorizes everything after it. Rehabilitative H codes such as H2014 and H2017 or H0036 are billable only when they are on a current, signed plan. A plan that lapses, or a service not listed on it, turns every claim against it into a recoupment risk, even if the service was delivered.
Common denials
- Wrong assessment code for the program. H0031 billed where the state expects 90791, or the reverse.
- Frequency limits. Reassessments inside the state's window deny without a documented change.
- Plan not current or not signed. Services billed after the plan's review date, or before required signatures.
- Credential mismatch. The staff member is not on the state's list for the code. Licensure modifiers often apply. See licensure and program modifiers.
The full code map is in H codes in behavioral health.
Federal HCPCS descriptors only. Your state Medicaid manual and each managed care contract define who may render the service, unit rules, caps, and rates. Verify against current guidance before billing.
Frequently asked questions
What is the H0031 code?
Mental health assessment by a non-physician. Many state Medicaid programs use it as the intake assessment in community and rehabilitative mental health programs, where a commercial payer would expect CPT 90791.
What is H0032?
Mental health service plan development by a non-physician: the treatment or service plan that later rehabilitative services are billed against.
What is the unit for H0031?
The descriptor does not define one. States set it, commonly per encounter, and some use time-based units.
Can H0031 and 90791 both be billed?
Some states allow both, split by program or credential; others pay only one. Check which your state expects for each program.
Assessments and plans, matched to what's billed.
See Stable check that every rehabilitative claim sits on a current, signed service plan before submission.
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