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See a sample rate comparisonHCPCS H0038 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.
Self-help/peer services, per 15 minutes
| Key Fact | Detail |
|---|---|
| Service Type | Alcohol and Drug Abuse Treatment Mental Health Programs and Medication Administration Training |
| Common Place of Service | 99 - Other POS 11 - Office 53 - Community Mental Health Center |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for H0038 |
National average reimbursement for HCPCS H0038 by major payers:
$57.53
$16.16
$3.22
$62.82
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HCPCS H0038
5 of 25 sample ratesHigher to lower in this preview
Positive Development Of California PC
$60.00Published rateGabriel Saltzman
Mass General Brigham Incorporated
$20.51Published rateNisha Warikoo
Nitin Nanda, Md
$19.62Published rateDavid Reiss
$19.36Published rateRachel Keller
$16.00Published rate
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See a sample payer proposalHCPCS H0038 vs. Other Mental Health Programs and Medication Administration Training Codes
The HCPCS H0038 code is part of the Alcohol and Drug Abuse Treatment services used for Mental Health Programs and Medication Administration Training. 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 H0038 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 |
|---|---|---|
| H0037-HCPCS | Low | Community psychiatric supportive treatment program, per diem |
| H0038-HCPCS | Low | Self-help/peer services, per 15 minutes |
| H0039-HCPCS | Low | Assertive community treatment, face-to-face, per 15 minutes |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS H0038. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the H0038 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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