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See a sample rate comparisonHCPCS H2031 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 clubhouse services, per diem
| Key Fact | Detail |
|---|---|
| Service Type | Alcohol and Drug Abuse Treatment Other Mental Health and Community Support Services |
| Common Place of Service | 11 - Office 53 - Community Mental Health Center 10 - Telehealth in Patient's Home |
| Complexity Level | Low |
National average reimbursement for HCPCS H2031 by major payers:
$57.41
$51.65
$12.10
$45.46
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HCPCS H2031
5 of 10 sample ratesHigher to lower in this preview
Crosbyton Clinic Hospital
$1,272.00Published rateRehabcare Group East, LLC, Rehabcare
$60.00Published rateRehabcare Group East, LLC, Rehabcare
$55.00Published rateRehabcare Group East, LLC, Rehabcare
$40.00Published rateRehabcare Group East, LLC, Rehabcare
$35.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS H2031 vs. Other Other Mental Health and Community Support Services Codes
The HCPCS H2031 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 H2031 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 |
|---|---|---|
| H2030-HCPCS | Low | Mental health clubhouse services, per 15 minutes |
| H2031-HCPCS | Low | Mental health clubhouse services, per diem |
| H2032-HCPCS | Low | Activity therapy, 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 H2031. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the H2031 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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