H0004 — Behavioral health counseling and therapy, per 15 minutes
H0004 is a HCPCS Level II code for behavioral health counseling and therapy, per 15 minutes. It belongs to the Behavioral Health and Substance Abuse Treatment section. Medicare does not pay it — see the coverage note below before you bill it.
Medicare coverage: Not payable by Medicare
Medicare does not pay this code. It may still be valid for another payer, but a Medicare claim carrying it will not be reimbursed.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusI
Not valid for Medicare purposes. Medicare uses another code.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
The CMS record for H0004
- Long descriptor
- Behavioral health counseling and therapy, per 15 minutes
- Short descriptor
- Alcohol and/or drug services
- Added
- January 1, 2001
- BETOS
- Z2
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to H0004
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If H0004 is not quite right, the correct code is very often within a few positions of it.
- G9995Patients who use palliative care services any time during the measurement periodterminated
- G9996Documentation stating the patient has received or is currently receiving palliative or hospice care
- G9997Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter
- G9998Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lower gastrointestinal bleeding, or patient at high risk for colon cancer due to underlying medical history ([i.e. crohn's disease, ulcerative colitis, personal or family history of colon cancer, hereditary colorectal cancer syndromes])
- G9999Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)
- H0001Alcohol and/or drug assessment
- H0002Behavioral health screening to determine eligibility for admission to treatment program
- H0003Alcohol and/or drug screening; laboratory analysis of specimens for presence of alcohol and/or drugs
- H0005Alcohol and/or drug services; group counseling by a clinician
- H0006Alcohol and/or drug services; case management
- H0007Alcohol and/or drug services; crisis intervention (outpatient)
- H0008Alcohol and/or drug services; sub-acute detoxification (hospital inpatient)
- H0009Alcohol and/or drug services; acute detoxification (hospital inpatient)
- H0010Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient)
- H0011Alcohol and/or drug services; acute detoxification (residential addiction program inpatient)
- H0012Alcohol and/or drug services; sub-acute detoxification (residential addiction program outpatient)
Questions about H0004
What is HCPCS code H0004?
H0004 is a HCPCS Level II code for behavioral health counseling and therapy, per 15 minutes. It sits in the Behavioral Health and Substance Abuse Treatment section.
Does Medicare cover H0004?
The CMS HCPCS file marks H0004 as "Not payable by Medicare". Medicare does not pay this code. It may still be valid for another payer, but a Medicare claim carrying it will not be reimbursed.
How is H0004 paid under the physician fee schedule?
H0004 carries PFS status code I. Not valid for Medicare purposes. Medicare uses another code.