HCPCS
H0010: Sub-Acute Detox (Residential) Billing Code
HCPCS H0010 is sub-acute detoxification in a residential addiction program. How it differs from H0011 and how payers pair it with revenue code 1002.
Last reviewed October 2026
Official descriptor
H0010: Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient)
When facilities use H0010
H0010 covers detoxification (withdrawal management) at a sub-acute level in a residential addiction program. Its sibling H0011 covers the acute level. H0012 and H0013 are the outpatient versions, and H0014 is ambulatory detox.
CMS lists it with coverage code I, not payable by Medicare. Commercial payers and Medicaid programs set their own rules for it.
Pairing examples
| Source | How H0010 is used |
|---|---|
| Point32Health | Revenue code 1002 + H0010 for clinical stabilization services (Level 3.5), one unit per day; H0010-UD for Level 3.5 on Rhode Island Medicaid professional claims |
| Evernorth Behavioral Health | Inpatient detox billed with room and board code 0126 (alternates 0116, 0136, 0146, 0156) and no HCPCS |
The same service can be billed two ways depending on the payer: a residential code with H0010, or a detox room and board code. Read the payer's guide before you build the claim.
Common denials and fixes
- Level of care disputed. The payer says the patient needed less than residential detox. CO-50; appeal with withdrawal scores and vitals by day.
- Billed as acute when the auth was sub-acute. N54 or CO-284. Match H0010 or H0011 to the auth.
- Short stays split across claims. Duplicates (OA-18) when a corrected claim goes out as new.
Questions
What is the difference between H0010 and H0011?
H0010 is sub-acute detox and H0011 is acute detox, both in a residential addiction program, per the CMS descriptors.
Do all payers want H0010 on detox claims?
No. Evernorth's guide bills inpatient detox with a room and board code and no HCPCS. Point32Health pairs 1002 with H0010.
Sources
- CMS, Alpha-numeric HCPCS file, October 2026 quarterly update (opens in a new tab)
- Point32Health, Inpatient and Intermediate/Diversionary BH/SUD Facility payment policy, rev. 06/2026 (PDF) (opens in a new tab)
- Evernorth Behavioral Health, Authorization and Billing Resource (PDF) (opens in a new tab)
Educational summary, not billing advice. Your contract and the payer's current guide decide how to bill.