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HCPCS

H0015: Substance Use Intensive Outpatient (IOP) Billing Code

HCPCS H0015 is alcohol and drug intensive outpatient treatment, at least 3 hours a day and 3 days a week. Pairing with revenue code 0906 and common denials.

Last reviewed October 2026

Official descriptor

H0015: Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education
CMS HCPCS file, October 2026

What the descriptor requires

H0015 is unusual because its descriptor sets a minimum: a program that runs at least 3 hours a day and at least 3 days a week, built on an individualized treatment plan. Notes that do not show those hours give the payer an easy denial.

CMS lists it with coverage code I, not payable by Medicare. Commercial payers and Medicaid programs set their own rules for it.

Revenue code pairing

Payer guideRevenue codeNotes
Evernorth Behavioral Health0906Preferred for substance use IOP; dual diagnosis IOP may use 0905 or 0906
BCBS of Mississippi0906One unit per date of service
Point32HealthNot statedH0015 as SUD IOP per day, with TF and TG modifiers for structured outpatient programs

Common denials and fixes

  • Fewer than 3 hours documented. CO-150. Keep start and end times in each day's note.
  • Billed with 0905. 0905 is the psychiatric IOP code; payers expect S9480 there. Fix with a corrected claim.
  • Missing modifier where required. CO-4.
  • Step-down from PHP without a new auth. CO-197.

Questions

How many units do I bill for H0015?

Payer guides such as BCBS of Mississippi call for one unit per date of service. Check the payer's guide for any different rule.

Can H0015 be billed on a CMS-1500?

Some programs bill it professionally. Facility claims put it on the UB-04 with revenue code 0906. Follow the payer and your contract.

Revenue code guide Denial code lookup

Sources

  1. CMS, Alpha-numeric HCPCS file, October 2026 quarterly update (opens in a new tab)
  2. Evernorth Behavioral Health, Authorization and Billing Resource (PDF) (opens in a new tab)
  3. Blue Cross & Blue Shield of Mississippi, Behavioral Health Coding Policy (opens in a new tab)
  4. Point32Health, Inpatient and Intermediate/Diversionary BH/SUD Facility payment policy, rev. 06/2026 (PDF) (opens in a new tab)

Educational summary, not billing advice. Your contract and the payer's current guide decide how to bill.

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