HCPCS H2011 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 • Other Mental Health and Community Support Services |
| Common Place of Service | • 11 - Office • 99 - Other POS • 53 - Community Mental Health Center |
| Complexity Level | Low |
National average reimbursement for HCPCS H2011 by major payers:
$51.07
$56.17
$20.40
$23.87
| 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 H2011 | ||||||
United | H2011 | $56.22 | 1083912109 - ERICA ZAMBON | 1497471734 | OR | Mental Health Counselor (101YM0800X) |
United | H2011 | $56.22 | 1013265644 - AMANDA PAINTER | 920986068 | OR | Adult Companion (372600000X) |
United | H2011 | $32.29 | 1316274855 - MARIA BLUM | 994448840 | OR | Mental Health Counselor (101YM0800X) |
United | H2011 | $56.22 | 1730516030 - ANDREA JOHNSON | 863626533 | OR | Professional Counselor (101YP2500X) |
United | H2011 | $56.22 | 1316246655 - JULIA SWOFFORD | 884331570 | OR | Psychiatric/Mental Health Nurse Practitioner (363LP0808X) |
United | H2011 | $50.13 | 1952714388 - ELLIE HARRINGTON | 934493187 | OR | Mental Health Counselor (101YM0800X) |
United | H2011 | $15.86 | 1942659297 - JESSICA FULLER | 800861810 | OR | Social Worker (104100000X) |
United | H2011 | $56.22 | 1063961902 - JENNIFER PURSWELL | 831901343 | OR | Mental Health Counselor (101YM0800X) |
United | H2011 | $56.22 | 1174991665 - ABIGAIL CHARLES | 232380812 | OR | Professional Counselor (101YP2500X) |
United | H2011 | $56.22 | 1750464939 - SHANNON KELLOW | 1750464939 | OR | Social Worker (104100000X) |
United | H2011 | $56.22 | 1154847655 - CATHERINE ADLER | 911256440 | OR | Mental Health Counselor (101YM0800X) |
United | H2011 | $56.22 | 1154651958 - RIKA COLLADO | 472461213 | OR | Psychologist (103T00000X) |
United | H2011 | $56.22 | 1972986750 - CALEB BARCENAS | 651205795 | OR | Community Health Worker (172V00000X) |
United | H2011 | $46.84 | 1316274855 - MARIA BLUM | 994448840 | OR | Mental Health Counselor (101YM0800X) |
United | H2011 | $56.22 | 1750464939 - SHANNON KELLOW | 1750464939 | OR | Social Worker (104100000X) |
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 H2011 vs. Other Other Mental Health and Community Support Services Codes
The HCPCS H2011 code is part of the Alcohol and Drug Abuse Treatment services used for Other Mental Health and Community Support 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 H2011 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 |
|---|---|---|
| H2010-HCPCS | Low | Comprehensive medication services, per 15 minutes |
| H2011-HCPCS | Low | Crisis intervention service, per 15 minutes |
| H2012-HCPCS | Low | Behavioral health day treatment, per hour |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS H2011. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the H2011 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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