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See a sample rate comparisonHCPCS H0019 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.
Behavioral health; long-term residential (non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem
| Key Fact | Detail |
|---|---|
| Service Type | Alcohol and Drug Abuse Treatment Drug, Alcohol, and Behavioral Health Services |
| Common Place of Service | None 99 - Other POS |
| Complexity Level | Low |
| ASAM Level | Level 3.3 - Clinically Managed Population-Specific High-Intensity Residential Level 3.5 - Clinically Managed High-Intensity Residential |
| Care Type | Treatment |
| Setting | Residential |
| Revenue Code | |
| Medicaid Fee Schedule | View Medicaid rates for H0019 |
National average reimbursement for HCPCS H0019 by major payers:
$64.89
$116.02
$129.19
$173.98
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HCPCS H0019
5 of 25 sample ratesHigher to lower in this preview
Cora Health Services Inc
Cora Health Services, Inc.
$60.00Published rateH2 Rehabilitation Services Of Florida LLC
$60.00Published rateH2 Rehabilitation Services Of Florida LLC
$40.00Published rateGenesis Eldercare Rehabilitation Services LLC
$35.00Published ratePowerback Rehabilitation LLC
$35.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS H0019 vs. Other Drug, Alcohol, and Behavioral Health Services Codes
The HCPCS H0019 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 H0019 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 |
|---|---|---|
| H0018-HCPCS | Low | Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem |
| H0019-HCPCS | Low | Behavioral health; long-term residential (non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem |
| H0020-HCPCS | Low | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS H0019. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the H0019 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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