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See a sample rate comparisonHCPCS H0013 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 outpatient)
| Key Fact | Detail |
|---|---|
| Service Type | Alcohol and Drug Abuse Treatment Drug, Alcohol, and Behavioral Health Services |
| Common Place of Service | 99 - Other POS 11 - Office None |
| Complexity Level | Moderate |
National average reimbursement for HCPCS H0013 by major payers:
$273.69
$51.00
$471.54
$25.86
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HCPCS H0013
5 of 25 sample ratesHigher to lower in this preview
Developmental Therapies And Beyond
$60.00Published rateAchieve Behavior Partners LLC
$55.00Published rateBlossoms Therapy Center Inc., Blossoms Developmental Therapy Associates
Blossoms Therapy Center Inc
$40.00Published rateDevelopmental Therapies And Beyond
$40.00Published rateDevelopmental Therapies And Beyond
$35.00Published rate
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See a sample payer proposalHCPCS H0013 vs. Other Drug, Alcohol, and Behavioral Health Services Codes
The HCPCS H0013 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 H0013 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 |
|---|---|---|
| H0012-HCPCS | Low | Alcohol and/or drug services; sub-acute detoxification (residential addiction program outpatient) |
| H0013-HCPCS | Moderate | Alcohol and/or drug services; acute detoxification (residential addiction program outpatient) |
| H0014-HCPCS | Low | Alcohol and/or drug services; ambulatory detoxification |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS H0013. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the H0013 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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