HCPCS H0005 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Alcohol and Drug Abuse Treatment • Drug, Alcohol, and Behavioral Health Services |
| Common Place of Service | • 11 - Office • 57 - Non-residential Substance Abuse Treatment Facility • None |
| Complexity Level | Low |
National average reimbursement for HCPCS H0005 by major payers:

$70.16

$45.51

$25.22

$19.92
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS H0005 | ||||||
United | H0005 | $39.00 | 1295149797 - WILLIAM GEORGE | 160743905 - ARNOT OGDEN MEDICAL CENTER | NY | Psychiatry Physician (2084P0800X) |
United | H0005 | $39.00 | 1295149797 - WILLIAM GEORGE | 1295149797 | NY | Psychiatry Physician (2084P0800X) |
United | H0005 | $23.87 | 1265680284 - GLENN DOYLE | 1265680284 - (PA) GLENN DOYLE | PA | Counselor (101Y00000X) |
United | H0005 | $39.00 | 1295149797 - WILLIAM GEORGE | 1295149797 | PA | Psychiatry Physician (2084P0800X) |
United | H0005 | $49.77 | 1316377906 - JEFFREY GLIDDEN | 42510564 - (MA) FENWAY COMMUNITY HEALTH CENTER INC | PA | Addiction (Substance Use Disorder) Counselor (101YA0400X) |
United | H0005 | $39.00 | 1295149797 - WILLIAM GEORGE | 160743905 - ARNOT OGDEN MEDICAL CENTER | NY | Psychiatry Physician (2084P0800X) |
United | H0005 | $39.00 | 1295149797 - WILLIAM GEORGE | 453800308 - ARNOT MEDICAL SERVICES PLLC | PA | Psychiatry Physician (2084P0800X) |
United | H0005 | $39.00 | 1295149797 - WILLIAM GEORGE | 453800308 - ARNOT MEDICAL SERVICES PLLC | PA | Psychiatry Physician (2084P0800X) |
United | H0005 | $39.00 | 1295149797 - WILLIAM GEORGE | 160743905 - ARNOT OGDEN MEDICAL CENTER | PA | Psychiatry Physician (2084P0800X) |
United | H0005 | $39.00 | 1295149797 - WILLIAM GEORGE | 453800308 - ARNOT MEDICAL SERVICES PLLC | PA | Psychiatry Physician (2084P0800X) |
United | H0005 | $39.00 | 1295149797 - WILLIAM GEORGE | 453800308 - ARNOT MEDICAL SERVICES PLLC | NY | Psychiatry Physician (2084P0800X) |
United | H0005 | $49.77 | 1316377906 - JEFFREY GLIDDEN | 42510564 - (MA) FENWAY COMMUNITY HEALTH CENTER INC | PA | Addiction (Substance Use Disorder) Counselor (101YA0400X) |
United | H0005 | $39.00 | 1295149797 - WILLIAM GEORGE | 160743905 - ARNOT OGDEN MEDICAL CENTER | PA | Psychiatry Physician (2084P0800X) |
United | H0005 | $39.00 | 1295149797 - WILLIAM GEORGE | 1295149797 | NY | Psychiatry Physician (2084P0800X) |
United | H0005 | $39.00 | 1295149797 - WILLIAM GEORGE | 1295149797 | PA | Psychiatry Physician (2084P0800X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS H0005 vs. Other Drug, Alcohol, and Behavioral Health Services Codes
The HCPCS H0005 code is part of the Alcohol and Drug Abuse Treatment services used for Drug, Alcohol, and Behavioral Health Services. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS H0005 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| H0004-HCPCS | Low | Behavioral health counseling and therapy, per 15 minutes |
| H0005-HCPCS | Low | Alcohol and/or drug services; group counseling by a clinician |
| H0006-HCPCS | Moderate | Alcohol and/or drug services; case management |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS H0005. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the H0005 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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