HCPCS
H0035: Mental Health Partial Hospitalization (PHP) Billing Code
HCPCS H0035 is mental health partial hospitalization, less than 24 hours. Revenue codes 0912 and 0913, units and common PHP denials.
Last reviewed October 2026
Official descriptor
H0035: Mental health partial hospitalization, treatment, less than 24 hours
When facilities use H0035
H0035 is the HCPCS code many commercial and Medicaid payers want on partial hospitalization lines. Payers use it for mental health, substance use and eating disorder PHP alike; Evernorth lists it as the preferred PHP code for all three.
CMS lists it with coverage code I, not payable by Medicare. Commercial payers and Medicaid programs set their own rules for it. CMS added H0035 to the HCPCS set in 2003.
Revenue codes and units
| Payer guide | Revenue code | Units |
|---|---|---|
| Evernorth Behavioral Health | 0912 or 0913 | Alternates listed: S0201, G0410, H2012 |
| Point32Health | 0912 | 1 unit = half day, 2 units = full day |
| BCBS of Mississippi | 0912 or 0913 | One unit per date of service |
Units are where PHP claims go wrong most. One payer counts half days, another counts days. Set units by the payer, not by a house rule.
Common denials and fixes
- Units do not match the payer's rule. Expect CO-151 or N362. Send a corrected claim with the right unit count.
- PHP billed while the auth is for IOP. CO-284 or N54. Match the level to the auth, or request the right one.
- Medical necessity at concurrent review. CO-50. Appeal with notes that show the PHP intensity the criteria require.
- HCPCS missing on the 0912 or 0913 line. CO-16 with M51. Add H0035 or the alternate the payer lists.
Questions
Is H0035 only for mental health PHP?
The descriptor says mental health, but payers such as Evernorth also list it for substance use and eating disorder PHP. Follow the payer's guide.
What is the difference between H0035 and S0201?
S0201 is partial hospitalization services, less than 24 hours, per diem. Evernorth lists H0035 as preferred and S0201 as an alternate.
Sources
- CMS, Alpha-numeric HCPCS file, October 2026 quarterly update (opens in a new tab)
- Evernorth Behavioral Health, Authorization and Billing Resource (PDF) (opens in a new tab)
- Point32Health, Inpatient and Intermediate/Diversionary BH/SUD Facility payment policy, rev. 06/2026 (PDF) (opens in a new tab)
- Blue Cross & Blue Shield of Mississippi, Behavioral Health Coding Policy (opens in a new tab)
Educational summary, not billing advice. Your contract and the payer's current guide decide how to bill.