HCPCS code
Residential treatment
CMS description
Behavioral health; long-term residential (non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days), 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