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See a sample rate comparisonHCPCS H0046 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.
Mental health services, not otherwise specified
| 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
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HCPCS H0046
5 of 25 sample ratesHigher to lower in this preview
Therapy Care Ltd
$60.00Published rateLake-Cook Psychologists And Counseling Associates, Lake-Cook Behavioral Health Resources
$37.50Published rateThe Twelve Of Ohio, Inc.
The Twelve Of Ohio Inc
$30.00Published rateHuman Development Center
$30.00Published rateAscension Medical Group-Fox Valley Wisconsin, Inc, Ascension Medical Group
Ascension Medical Group-Fox Valley Wisconsin Inc
$0.51Published rate
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See a sample payer proposalHCPCS 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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