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 2026Q4-Oct. 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)