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Facility H codes

Julie Posted Thu 14th of November, 2013 16:30:06 PM


We recently got denied fo using the H0035, H0019, and H2036 by BC.
I'm showing this as a valid code on here. Not understanding the Medicaid portion?
Is anyone having this issues? Any help is appreciated

SuperCoder Answered Fri 15th of November, 2013 10:36:46 AM


We are working on this. Kindly bear with us.


Julie Posted Fri 15th of November, 2013 16:11:31 PM


Any luck on these codes?

SuperCoder Answered Mon 18th of November, 2013 04:44:42 AM

As per CMS, the H-code section of the HCPCS codes are to be used by those state Medicaid agencies that are mandated by state law to establish separate codes for mental health services including alcohol and drug treatment. The "Medicaid portion" of the H codes in Supercoder refers to this policy only, as you had correctly noticed. Now, since these H codes are to be used by "state Medicaid agencies" only that are governed by their respective state laws for using these codes, commercial payors like BC/BS and also Medicare will not recognize these codes for their payment. You would need to consult your payors reimbursement policies regarding the Mental Health Services that are represented by these H codes.

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