# Service Type Code Lookup

Find the service type codes to send in an eligibility check for a procedure code or a kind of care. VerifyTX checks any service type a payer returns.

## Service Type Codes by Type of Care

### Behavioral health

| Type of care | Procedure codes | Service type codes |
| --- | --- | --- |
| Psychiatric evaluation | 90791, 90792 | MH Mental Health; CF Mental Health Provider - Outpatient; A6 Psychotherapy; A8 Psychiatric - Outpatient; A4 Psychiatric; BD Cognitive Therapy; 98 Professional (Physician) Visit - Office; 96 Professional (Physician) |
| Psychotherapy | 90832, 90833, 90834, 90836, 90837, 90838, 90839, 90840, 90845, 90846, 90847, 90849, 90853 | MH Mental Health; CF Mental Health Provider - Outpatient; A6 Psychotherapy; A8 Psychiatric - Outpatient; A4 Psychiatric; BD Cognitive Therapy; 98 Professional (Physician) Visit - Office; 96 Professional (Physician) |
| Psychological testing | 96130, 96131, 96132, 96133, 96136, 96137 | MH Mental Health; CF Mental Health Provider - Outpatient; A6 Psychotherapy; A8 Psychiatric - Outpatient; A4 Psychiatric; 98 Professional (Physician) Visit - Office; 96 Professional (Physician) |
| Psychiatric intensive outpatient | S9480 | MH Mental Health; CF Mental Health Provider - Outpatient; CH Mental Health Facility - Outpatient; A8 Psychiatric - Outpatient; A4 Psychiatric; BB Partial Hospitalization (Psychiatric) |
| Psychiatric partial hospitalization | H0035 | BB Partial Hospitalization (Psychiatric); MH Mental Health; CH Mental Health Facility - Outpatient |
| Residential treatment | H0017, H0018, H0019 | RT Residential Psychiatric Treatment; CI Substance Abuse Facility - Inpatient; CG Mental Health Facility - Inpatient; AI Substance Abuse; A7 Psychiatric - Inpatient; AJ Alcoholism; AK Drug Addiction; MH Mental Health |
| Inpatient psychiatric care | Billed without a procedure code | A7 Psychiatric - Inpatient; CG Mental Health Facility - Inpatient; MH Mental Health |
| Applied behavior analysis (ABA) | 97151, 97152, 97153, 97154, 97155, 97156, 97157 | BD Cognitive Therapy; MH Mental Health |
| Transcranial magnetic stimulation (TMS) | 90867 | A4 Psychiatric; MH Mental Health |

Applied behavior analysis (ABA): HIPAA 5010 has no ABA code. Payers most often return ABA under Cognitive Therapy or Mental Health.

### Substance use

| Type of care | Procedure codes | Service type codes |
| --- | --- | --- |
| Substance use treatment | 90791, 90832, 90834, 90837, 90853, 99408, 99409 | AI Substance Abuse; AJ Alcoholism; AK Drug Addiction; MH Mental Health |
| Substance use intensive outpatient | H0015 | CJ Substance Abuse Facility - Outpatient; AI Substance Abuse; BB Partial Hospitalization (Psychiatric) |
| Substance use assessment and counseling | H0001, H0004, H0005 | AI Substance Abuse; AJ Alcoholism; AK Drug Addiction; MH Mental Health |
| Withdrawal management (detox) | H0010, H0011, H0012, H0014 | CI Substance Abuse Facility - Inpatient; AI Substance Abuse; AJ Alcoholism; AK Drug Addiction; MH Mental Health |
| Substance use treatment program | H2035, H2036 | CJ Substance Abuse Facility - Outpatient; AI Substance Abuse; AJ Alcoholism; AK Drug Addiction; MH Mental Health |

### Therapy and rehab

| Type of care | Procedure codes | Service type codes |
| --- | --- | --- |
| Physical therapy | 97110, 97112, 97116, 97140, 97161, 97162, 97163, 97530 | PT Physical Therapy; AE Physical Medicine |
| Occupational therapy | 97165, 97166, 97167, 97168, 97110, 97530, 97112, 97140, 97535, 97116, 97129 | AD Occupational Therapy; 98 Professional (Physician) Visit - Office |
| Speech therapy | 92507, 92508, 92521, 92522, 92523, 92524, 92526, 92605, 92607, 92609, 92618 | AF Speech Therapy; 98 Professional (Physician) Visit - Office |
| Rehabilitation | Billed without a procedure code | A9 Rehabilitation; AA Rehabilitation - Room and Board; AB Rehabilitation - Inpatient; AC Rehabilitation - Outpatient |

### Post-acute care

| Type of care | Procedure codes | Service type codes |
| --- | --- | --- |
| Skilled nursing | 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316 | AG Skilled Nursing Care; AH Skilled Nursing Care - Room and Board |
| Home health care | G0299, G0300 | 42 Home Health Care; 44 Home Health Visits |
| Hospice | Q5001, Q5002, Q5003 | 45 Hospice |
| Long-term care | Billed without a procedure code | 54 Long Term Care |

Long-term care: Many payers return plan status only for long-term care; confirm the benefit with the payer.

### Medical

| Type of care | Procedure codes | Service type codes |
| --- | --- | --- |
| Office visit | 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215 | 1 Medical Care; 98 Professional (Physician) Visit - Office; BY Physician Visit - Office: Sick |
| General plan coverage | Billed without a procedure code | 30 Health Benefit Plan Coverage |

General plan coverage: Code 30 asks for the plan's overall benefits; most payers return several service types for it.

### DME

| Type of care | Procedure codes | Service type codes |
| --- | --- | --- |
| Durable medical equipment | E0260, E0601, E1390, E1399, K0001 | DM Durable Medical Equipment; 11 Used Durable Medical Equipment; 12 Durable Medical Equipment Purchase; 18 Durable Medical Equipment Rental |

### Vision

| Type of care | Procedure codes | Service type codes |
| --- | --- | --- |
| Eye exam | 92004, 92014, 92015 | AN Routine Exam; AL Vision (Optometry); BR Eye |
| Frames and lenses | V2020, V2100, V2200, V2300 | AL Vision (Optometry); AM Frames; AO Lenses; CP Eyewear and Eyewear Accessories; AN Routine Exam; BR Eye |

### Dental

| Type of care | Procedure codes | Service type codes |
| --- | --- | --- |
| Diagnostic (exams and X-rays) | D0120, D0140, D0150, D0210, D0274, D0330 | 23 Diagnostic Dental; 35 Dental Care |
| Preventive (cleanings, fluoride, sealants) | D1110, D1120, D1206, D1208, D1351 | 41 Routine (Preventive) Dental; 35 Dental Care |
| Restorative (fillings and crowns) | D2140, D2330, D2391, D2392, D2740, D2750 | 25 Restorative; 35 Dental Care |
| Endodontics (root canals) | D3310, D3320, D3330 | 26 Endodontics; 35 Dental Care |
| Periodontics | D4341, D4342, D4910 | 24 Periodontics; 35 Dental Care |
| Prosthodontics (dentures and bridges) | D5110, D5120, D6240, D6750 | 39 Prosthodontics; 35 Dental Care |
| Oral surgery (extractions) | D7140, D7210 | 40 Oral Surgery; 35 Dental Care |
| Orthodontics | D8080, D8090 | 38 Orthodontics; 35 Dental Care |
| Adjunctive services (anesthesia, night guards) | D9222, D9230, D9944 | 28 Adjunctive Dental Services; 35 Dental Care |

These are the service type codes payers most often recognize. What a check returns depends on the payer.

[Find a payer ID](https://www.verifytx.com/payers/)

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