H0039 and H0040 Code Descriptions: Assertive Community Treatment (ACT)
Assertive community treatment is a team, not a session, and the billing reflects that: one per diem whose rate depends on which team member delivered the contact.
Short answer
H0039 is "Assertive community treatment, face-to-face, per 15 minutes" and H0040 is "Assertive community treatment program, per diem." Ohio bills ACT as H0040 per diem with a modifier for the team member: $694.13 for an MD or DO (AM), $397.73 for a CNP, CNS, or PA, $284.03 for a licensed practitioner (HO), $225.16 for an unlicensed practitioner (HN), and $179.54 for a certified peer supporter (HM), and requires prior authorization.
| Code | HCPCS descriptor | Unit |
|---|---|---|
| H0039 | Assertive community treatment, face-to-face, per 15 minutes | 15 minutes |
| H0040 | Assertive community treatment program, per diem | Day |
Ohio: H0040 by team member
| Rendering team member | Modifier | Ohio rate (per diem) |
|---|---|---|
| MD/DO | AM | $694.13 |
| CNP | UC | $397.73 |
| CNS or PA | SA | $397.73 |
| Licensed practitioner | HO | $284.03 |
| Unlicensed practitioner | HN | $225.16 |
| Certified peer supporter | HM | $179.54 |
Ohio Medicaid manual v1.28.1, Table 3-14. ACT must be prior authorized, and SUD services above ASAM level 1 must be prior authorized for ACT enrollees.
Michigan's ACT modifiers
Michigan reports pre-admission screening done as part of ACT with its state modifier WN and family psychoeducation provided as part of ACT with WV, both state-defined modifiers in its SFY 2027 code sets.
Colorado: H0039 or H0036
Colorado's manual lists H0039 (per 15 minutes) and H0040 (per diem) for ACT, and allows H0036 as an alternative to H0039 for people enrolled in a program not overseen by an ACT fidelity review process.
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 H0039 and H0040. 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 ACT denials
- No prior authorization. Ohio requires it for ACT, and for SUD services above ASAM 1 for ACT enrollees.
- Team member modifier missing. The per diem cannot be priced without the rendering member's modifier.
- Not an enrolled ACT team. The billing agency is not certified or enrolled for ACT.
Related: behavioral health modifiers and H codes in behavioral health.
Sources, read October 2026: Ohio Medicaid Behavioral Health Provider Manual, v1.28.1 (March 2026); MDHHS SFY 2027 Behavioral Health Code Charts and Provider Qualifications; 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 H0040 code description?
H0040 is "Assertive community treatment program, per diem."
What is the difference between H0039 and H0040?
H0039 bills assertive community treatment face-to-face in 15-minute units; H0040 bills the ACT program as a per diem. States choose which their ACT programs use.
Does ACT need prior authorization in Ohio?
Yes. Ohio requires prior authorization for ACT, and for SUD services above ASAM level 1 for people enrolled in ACT.
Does Ambetter cover H0039 and H0040 in 2027?
No. Both are on Ambetter's list of H codes it stops covering on January 1, 2027.
ACT claims priced by the right team member.
See Stable apply team member modifiers and check authorizations on every ACT claim.
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