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H2035 Service Type Codes to Send

HCPCS code

Substance use treatment program

CMS description

Alcohol and/or other drug treatment program, per hour

Why these codes

Hourly and per diem program billing, most often outpatient.

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

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