HCPCS H0031 reports a mental health assessment performed by a non-physician, such as a licensed counselor or social worker, to determine service needs.
When to use H0031
Use H0031 for a Medicaid mental health assessment conducted by a non-physician. It is distinct from the CPT diagnostic evaluation 90791 and from the substance use assessment H0001.
How to bill it
Report per assessment, following the relevant state Medicaid program’s definitions and limits.
Common pitfalls
- Confusing H0031 with the CPT diagnostic evaluation 90791.
- Assuming national rules for a state-defined H-code.
Frequently asked questions
How does H0031 differ from 90791?
H0031 is a Medicaid mental health assessment by a non-physician; 90791 is the CPT psychiatric diagnostic evaluation used across payers.
Can H0031 be billed by physicians?
H0031 is specifically for assessments by non-physicians; confirm the credentialing rules in your state Medicaid manual.