HH Modifier: Integrated Mental Health and Substance Use Program
People with co-occurring mental health and substance use disorders do best in integrated treatment, and HH is the modifier that tells a payer the service was delivered that way.
Short answer
HH is the HCPCS Level II modifier "Integrated mental health/substance abuse program." It identifies services delivered in a program that treats co-occurring mental health and substance use disorders together. Michigan lists HH as a current rating modifier, and reports SAMHSA-approved evidence-based practice for co-occurring disorders with its own modifier Y4, which previously used HH with TG.
| Modifier | HCPCS descriptor | Type |
|---|---|---|
| HH | Integrated mental health/substance abuse program | Program |
How Michigan uses HH
Michigan's SFY 2027 code sets list HH as a method modifier that affects the rate, in current use. Residential room and board (S9976) can carry HH for integrated programs, and the state's Y4 modifier now marks SAMHSA-approved evidence-based practice for co-occurring disorders, a role HH shared with TG before.
When HH fits
HH describes the program, not the person: use it where the service is delivered within an integrated co-occurring program the payer recognizes, not simply because a client has both diagnoses. Payers that use HH usually define which programs qualify in their code set or contract.
Why HH claims deny
- Not an integrated program. HH added because of a dual diagnosis, without a recognized integrated program.
- State modifier expected. The payer reports the evidence-based practice with a state modifier, such as Michigan's Y4.
- Program modifier conflicts. HH combined with a mental-health-only or SUD-only program modifier the payer treats as mutually exclusive.
Related: H0001 and H0002, all behavioral health HCPCS modifiers, and the code map in H codes in behavioral health.
Sources, read October 2026: MDHHS SFY 2027 Behavioral Health Code Charts and Provider Qualifications. Federal HCPCS descriptors are CMS public data. State manuals and plan contracts change; confirm the current edition before billing.
Frequently asked questions
What is the HH modifier?
HH is the HCPCS Level II modifier "Integrated mental health/substance abuse program."
When should the HH modifier be used?
When the service is delivered in an integrated program that treats co-occurring mental health and substance use disorders together, and the payer's code set calls for it.
Is a dual diagnosis enough to use HH?
Generally no. HH describes an integrated program, not the client's diagnoses. Check how your payer defines qualifying programs.
Co-occurring programs, coded to the payer's rules.
See Stable apply program modifiers like HH according to each payer's code set.
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