HCPCS H0004 reports behavioral health counseling and therapy, defined per 15 minutes. It is a general Medicaid counseling code used across behavioral health services.
When to use H0004
Use H0004 for general behavioral health counseling and therapy delivered in 15-minute units, as defined by the official descriptor. It is distinct from the psychotherapy CPT codes used by most commercial payers.
How to bill it
Report per 15-minute unit, following the relevant state Medicaid program’s rules.
Common pitfalls
- Confusing the Medicaid H0004 counseling code with CPT psychotherapy codes.
- Assuming uniform unit definitions across states.
Frequently asked questions
When do I use H0004 instead of 90834?
Use H0004 for Medicaid behavioral health counseling defined per 15 minutes; commercial payers typically use the CPT psychotherapy codes such as 90834.
Is H0004 time-based?
Yes. The official HCPCS descriptor defines it per 15 minutes, though state programs may set additional rules.