HCPCS code
Medical services in a substance use program
CMS description
Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)
In the order to send them
Why these codes
Medical care delivered inside a substance use program; medical care is the fallback.
If a payer returns nothing
Payers don't all answer every service type. Send 30 (Health Benefit Plan Coverage) for the plan's general benefits.
Sources
CMS HCPCS Level II descriptor; X12 HIPAA 5010 service type code definitions; VerifyTX billing practice