Question 1

What is HCPCS code H0019?

Accepted Answer

HCPCS code H0019 is "Alcohol and/or drug services". Behavioral health; long-term residential (non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem

Question 2

What category is H0019 in?

Accepted Answer

H0019 belongs to HCPCS Category H (Alcohol and Drug Abuse Treatment).

Question 3

When should I use HCPCS code H0019?

Accepted Answer

Use H0019 when billing for alcohol and/or drug services. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is H0019 covered by Medicare?

Accepted Answer

Coverage for H0019 (Alcohol and/or drug services) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for H0019?

Accepted Answer

Documentation for H0019 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).