HCPCS H0049 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 | • 11 - Office • 50 - Federally Qualified Health Center • None |
| Complexity Level | Low |
National average reimbursement for HCPCS H0049 by major payers:
$63.99
$17.50
$0.94
$13.30
| 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 H0049 | ||||||
United | H0049 | $12.69 | 1629144761 - FAMILY SERVICE CENTER AT HOUSTON AND HARRIS COUNTY, FAMILY SERVICES OF GREATER HOUSTON | 741152613 - (TX) FAMILY SERVICE CENTER AT HOUSTON AND HARRIS COUNTY | TX | Community/Behavioral Health Agency (251S00000X) |
United | H0049 | $12.69 | 1083755672 - FAMILY MENTAL HEALTH CENTER, INC. | 760523037 - (TX) FAMILY MENTAL HEALTH CENTER INC | TX | Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X) |
United | H0049 | $12.69 | 1720193899 - THE CENTER FOR INTEGRATIVE COUNSELING AND PSYCHOLOGY, PASTORAL COUNSELING AND EDUCATION CENTER | 751494691 - (TX) THE CENTER FOR INTEGRATIVE COUNSELING AND PSYCHOLOGY | TX | Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X) |
United | H0049 | $12.69 | 1336369669 - TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER LUBBOCK, TTUHSC | 752668014 | TX | Multi-Specialty Clinic/Center (261QM1300X) |
United | H0049 | $1272.00 | 1063500270 - CROSBYTON CLINIC HOSPITAL | 750711276 - (TX) CROSBYTON CLINIC HOSPITAL | TX | Rural Acute Care Hospital (282NR1301X) |
United | H0049 | $12.69 | 1912999715 - ROBERT F MEHL III PHD & ASSOC LLC, THE LAKEWOOD GROUP | 752516981 - (TX) ROBERT F MEHL III PHD ASSOC LLC | TX | Multi-Specialty Clinic/Center (261QM1300X) |
United | H0049 | $12.69 | 1770573586 - MCALLEN HOSPITALS L P, SOUTH TEXAS HEALTH SYSTEM | 742721122 | TX | General Acute Care Hospital (282N00000X) |
United | H0049 | $12.69 | 1255427548 - MCALLEN PSYCHOLOGICAL CENTER | 742576520 - (TX) MCALLEN PSYCHOLOGICAL CENTER | TX | Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X) |
United | H0049 | $25.00 | 1154833317 - PREMISE HEALTH OF TEXAS MEDICAL, P.A, ROSS AVENUE HEALTH CENTER | 752806777 | TX | Multi-Specialty Clinic/Center (261QM1300X) |
United | H0049 | $25.00 | 1154833317 - PREMISE HEALTH OF TEXAS MEDICAL, P.A, ROSS AVENUE HEALTH CENTER | 752806777 | TX | Multi-Specialty Clinic/Center (261QM1300X) |
United | H0049 | $1272.00 | 1063500270 - CROSBYTON CLINIC HOSPITAL | 750711276 - (TX) CROSBYTON CLINIC HOSPITAL | TX | Rural Acute Care Hospital (282NR1301X) |
United | H0049 | $12.69 | 1801936133 - SAMARITAN CENTER FOR COUNSELING AND PASTORAL CARE, INC. | 741832864 - (TX) SAMARITAN CENTER FOR COUNSELING AND PASTORAL CARE INC | TX | Community/Behavioral Health Agency (251S00000X) |
United | H0049 | $12.69 | 1093904385 - PSYCHIATRIC CONSULTANTS OF FT WORTH PA | 751721188 | TX | Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X) |
United | H0049 | $12.69 | 1780053579 - RECLAMATION COUNSELING CENTER, PC | 742953338 - (TX) RECLAMATION COUNSELING CENTER PC | TX | Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X) |
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 H0049 vs. Other Miscellaneous Drug and Alcohol Services Codes
The HCPCS H0049 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 H0049 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 |
|---|---|---|
| H0048-HCPCS | Low | Alcohol and/or other drug testing: collection and handling only, specimens other than blood |
| H0049-HCPCS | Low | Alcohol and/or drug screening |
| H0050-HCPCS | Low | Alcohol and/or drug services, brief intervention, 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 H0049. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the H0049 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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