HCPCS code
Residential treatment
CMS description
Behavioral health; residential (hospital residential treatment program), without room and board, per diem
In the order to send them
Why these codes
Residential has its own STC; then inpatient facility for mental health and for substance use, since programs treat either, then the umbrellas.
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