PayerPrice
Data Platform
Who We Serve
Use Cases
More
Check Local Rates

HCPCS H0011 Fee Schedule

Last Verified: September 2026

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; acute detoxification (residential addiction program inpatient)
Key FactDetail
Service Type

Alcohol and Drug Abuse Treatment

Drug, Alcohol, and Behavioral Health Services

Common Place of Service

None

53 - Community Mental Health Center

Complexity LevelLow
ASAM Level

Level 3.7 - Medically Managed Residential

Care Type

Withdrawal Mgmt

Setting

Residential

Revenue Code
Medicaid Fee ScheduleView Medicaid rates for H0011

National average reimbursement for HCPCS H0011 by major payers:

bcbs

$69.95

uhc

$124.87

aetna

$295.03

cigna

$228.02

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS H0011.

HCPCS H0011
5 of 25 sample ratesHigher to lower in this preview
  1. Genesis Health Development Inc

    FLRehabilitation Clinic/CenterNPI 1033154992Tax ID 59-2249372

    $60.00Published rate
  2. Rehab Rx Corp

    FLRehabilitation Clinic/CenterNPI 1265430003Tax ID 59-3531841

    $60.00Published rate
  3. Two Gs Of Broward Inc

    FLComprehensive Outpatient Rehabilitation Facility (CORF)NPI 1528092483Tax ID 65-0775782

    $55.00Published rate
  4. South Psychological & Physical Rehabilitation,Inc

    South Psychological Physical Rehabilitationinc

    FLComprehensive Outpatient Rehabilitation Facility (CORF)NPI 1790705101Tax ID 65-0853792

    $40.00Published rate
  5. Powerback Rehabilitation LLC

    FLRehabilitation Clinic/CenterNPI 1801281860Tax ID 23-2446104

    $35.00Published rate

National sample. Rates vary by location, specialty, and contract.

Get a free rate benchmark for your specialty.

Choose your state and specialty to build a report from payer-published rates.

Use market rates to prepare your payer proposal.

Rate Benchmarking

Compare your rates with similar providers.

Select a published rate, define comparable providers, and see where that rate falls in your market.

See a sample rate comparison

Payer Contract Negotiation

Draft a fee schedule renegotiation letter.

Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.

See a sample payer proposal

HCPCS H0011 vs. Other Drug, Alcohol, and Behavioral Health Services Codes

The HCPCS H0011 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 H0011 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
H0010-HCPCSLowAlcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient)
H0011-HCPCSLowAlcohol and/or drug services; acute detoxification (residential addiction program inpatient)
H0012-HCPCSLowAlcohol and/or drug services; sub-acute detoxification (residential addiction program outpatient)

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS H0011. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the H0011 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.

FREE SAMPLE MARKET COMPARISON

Let's review your payer contracts side-by-side with the market.

Bring your top codes (like HCPCS H0011) and we'll show you how you compare in 15 minutes or less.