HCPCS H0046 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Alcohol and Drug Abuse Treatment • Miscellaneous Drug and Alcohol Services |
| Common Place of Service | • 99 - Other POS • None • 11 - Office |
| Complexity Level | Moderate |
National average reimbursement for HCPCS H0046 by major payers:
$218.08
$35.74
$6.88
$8.61
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS H0046 | ||||||
United | H0046 | $30.00 | 1255669354 - DOVETREE COUNSELING ASSOCIATES, INC. | 201317958 - (AZ) DOVETREE COUNSELING ASSOCIATES INC | AZ | Community/Behavioral Health Agency (251S00000X) |
United | H0046 | $37.50 | 1790371847 - DELVE PSYCHOTHERAPY OF CHICAGO | 843452526 - (IL) TRANSCEND COUNSELING CHICAGO LLC | IL | Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X) |
United | H0046 | $30.00 | 1942735667 - EVERGREEN AT NORTHPOINT LLC, IMAGINE BY NORTHPOINT SPOKANE | 611806378 | WA | Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X) |
United | H0046 | $87.00 | 1972188555 - BEAVER DAM COMMUNITY HOSPITALS INC, MARSHFIELD MEDICAL CENTER - BEAVER DAM PROFESSIONAL SERVICES | 391157876 - BEAVER DAM COMMUNITY HOSPITALS INC | WI | Clinic/Center (261Q00000X) |
United | H0046 | $0.51 | 1730346214 - ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN, INC, ASCENSION MEDICAL GROUP | 391127163 - ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN INC | WI | Multi-Specialty Clinic/Center (261QM1300X) |
United | H0046 | $29.00 | 1891808648 - NEWARK-GRANVILLE PSYCHOLOGICAL & COUNSELING SERVICES LTD | 311417010 - (OH) NEWARKGRANVILLE PSYCHOLOGICAL COUNSELING SERVICES LTD | OH | Adult Mental Health Clinic/Center (261QM0850X) |
United | H0046 | $30.00 | 1194051532 - MARION AREA COUNSELING CENTER, INC. | 310937618 - (OH) MARION AREA COUNSELING CENTER INC | OH | Community/Behavioral Health Agency (251S00000X) |
United | H0046 | $30.00 | 1659509552 - FAIRVIEW EXPRESS CARE, M HEALTH FAIRVIEW COUNSELING EDINA | 410991680 - FAIRVIEW HEALTH SERVICES | MN | Clinic/Center (261Q00000X) |
United | H0046 | $30.00 | 1891094504 - CREATIVE SOLUTIONS FOR KIDS AND FAMILIES | 331096142 - (MO) CREATIVE SOLUTIONS FOR KIDS AND FAMILIES | MO | Community/Behavioral Health Agency (251S00000X) |
United | H0046 | $21.47 | 1326193269 - DIMOCK COMMUNITY SERVICES CORPORATION, DIMOCK COMMUNITY SERVICES CORP. | 43487833 - (MA) DIMOCK COMMUNITY FOUNDATION INC | MA | Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X) |
United | H0046 | $30.00 | 1881644581 - LEE A WOODS LCSW PC | 203180931 - (AZ) LEE A WOODS LCSW PC | AZ | Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X) |
United | H0046 | $30.00 | 1043752058 - JOSEPH HOUSE | 311383835 - (OH) JOSEPH HOUSE | OH | Substance Abuse Rehabilitation Facility (324500000X) |
United | H0046 | $30.00 | 1376663468 - HUMAN DEVELOPMENT CENTER | 410777937 - HUMAN DEVELOPMENT CENTER | MN | Community/Behavioral Health Agency (251S00000X) |
United | H0046 | $30.00 | 1154372381 - FIRELANDS REGIONAL MEDICAL CENTER, FIRELANDS COUNSELING & RECOVERY SERVICES | 344428218 - (OH) FIRELANDS REGIONAL MEDICAL CENTER | OH | Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X) |
United | H0046 | $30.00 | 1134557390 - NORTHWEST AUTISM CENTER | 571138106 - (WA) NORTHWEST AUTISM CENTER | WA | Community/Behavioral Health Agency (251S00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS H0046 vs. Other Miscellaneous Drug and Alcohol Services Codes
The HCPCS H0046 code is part of the Alcohol and Drug Abuse Treatment services used for Miscellaneous Drug and Alcohol 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 H0046 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 |
|---|---|---|
| H0045-HCPCS | Low | Respite care services, not in the home, per diem |
| H0046-HCPCS | Moderate | Mental health services, not otherwise specified |
| H0047-HCPCS | Moderate | Alcohol and/or other drug abuse services, not otherwise specified |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS H0046. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the H0046 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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