H1003 — Prenatal care, at-risk enhanced service; education
H1003 is a HCPCS Level II code for prenatal care, at-risk enhanced service; education. 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 H1003
- Long descriptor
- Prenatal care, at-risk enhanced service; education
- Short descriptor
- Prenatal at risk education
- Added
- January 1, 2002
- 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 H1003
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If H1003 is not quite right, the correct code is very often within a few positions of it.
- H0049Alcohol and/or drug screening
- H0050Alcohol and/or drug services, brief intervention, per 15 minutes
- H0051Traditional healing service
- H0052Missing and murdered indigenous persons (mmip) mental health and clinical care
- H0053Historical trauma (ht) mental health and clinical care for indigenous persons
- H1000Prenatal care, at-risk assessment
- H1001Prenatal care, at-risk enhanced service; antepartum management
- H1002Prenatal care, at risk enhanced service; care coordination
- H1004Prenatal care, at-risk enhanced service; follow-up home visit
- H1005Prenatal care, at-risk enhanced service package (includes h1001-h1004)
- H1010Non-medical family planning education, per session
- H1011Family assessment by licensed behavioral health professional for state defined purposes
- H2000Comprehensive multidisciplinary evaluation
- H2001Rehabilitation program, per 1/2 day
- H2010Comprehensive medication services, per 15 minutes
- H2011Crisis intervention service, per 15 minutes
Questions about H1003
What is HCPCS code H1003?
H1003 is a HCPCS Level II code for prenatal care, at-risk enhanced service; education. It sits in the Behavioral Health and Substance Abuse Treatment section.
Does Medicare cover H1003?
The CMS HCPCS file marks H1003 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 H1003 paid under the physician fee schedule?
H1003 carries PFS status code I. Not valid for Medicare purposes. Medicare uses another code.