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HCPCS H0005 Fee Schedule

Last Verified: December 2025

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.

Alcohol and/or drug services; group counseling by a clinician
Key FactDetail
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 LevelLow

National average reimbursement for HCPCS H0005 by major payers:

bcbs

$70.16

uhc

$45.51

aetna

$25.22

cigna

$19.92

Preview provider-level rates for...
For billing codeHCPCS H0005
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS H0005

United
H0005$39.001295149797 - WILLIAM GEORGE160743905 - ARNOT OGDEN MEDICAL CENTERNYPsychiatry Physician (2084P0800X)
United
H0005$39.001295149797 - WILLIAM GEORGE1295149797NYPsychiatry Physician (2084P0800X)
United
H0005$23.871265680284 - GLENN DOYLE1265680284 - (PA) GLENN DOYLEPACounselor (101Y00000X)
United
H0005$39.001295149797 - WILLIAM GEORGE1295149797PAPsychiatry Physician (2084P0800X)
United
H0005$49.771316377906 - JEFFREY GLIDDEN42510564 - (MA) FENWAY COMMUNITY HEALTH CENTER INCPAAddiction (Substance Use Disorder) Counselor (101YA0400X)
United
H0005$39.001295149797 - WILLIAM GEORGE160743905 - ARNOT OGDEN MEDICAL CENTERNYPsychiatry Physician (2084P0800X)
United
H0005$39.001295149797 - WILLIAM GEORGE453800308 - ARNOT MEDICAL SERVICES PLLCPAPsychiatry Physician (2084P0800X)
United
H0005$39.001295149797 - WILLIAM GEORGE453800308 - ARNOT MEDICAL SERVICES PLLCPAPsychiatry Physician (2084P0800X)
United
H0005$39.001295149797 - WILLIAM GEORGE160743905 - ARNOT OGDEN MEDICAL CENTERPAPsychiatry Physician (2084P0800X)
United
H0005$39.001295149797 - WILLIAM GEORGE453800308 - ARNOT MEDICAL SERVICES PLLCPAPsychiatry Physician (2084P0800X)
United
H0005$39.001295149797 - WILLIAM GEORGE453800308 - ARNOT MEDICAL SERVICES PLLCNYPsychiatry Physician (2084P0800X)
United
H0005$49.771316377906 - JEFFREY GLIDDEN42510564 - (MA) FENWAY COMMUNITY HEALTH CENTER INCPAAddiction (Substance Use Disorder) Counselor (101YA0400X)
United
H0005$39.001295149797 - WILLIAM GEORGE160743905 - ARNOT OGDEN MEDICAL CENTERPAPsychiatry Physician (2084P0800X)
United
H0005$39.001295149797 - WILLIAM GEORGE1295149797NYPsychiatry Physician (2084P0800X)
United
H0005$39.001295149797 - WILLIAM GEORGE1295149797PAPsychiatry Physician (2084P0800X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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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.

CodeComplexityDescription
H0004-HCPCSLowBehavioral health counseling and therapy, per 15 minutes
H0005-HCPCSLowAlcohol and/or drug services; group counseling by a clinician
H0006-HCPCSModerateAlcohol 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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