Facility claims for substance use and mental health programs go out on the UB-04 (the 837I electronic claim). The revenue code on each line tells the payer what level of care you billed. If it does not match the authorization or the payer's billing guide, the claim can deny before anyone reads the chart.
This guide lists the behavioral health revenue codes facilities use most, the HCPCS codes payers often want next to them, and the denials that follow common mistakes.
Key points
- The revenue code tells the payer which level of care you billed.
- HCPCS pairing is set by each payer, not by a national rule.
- Most code denials are fixed with a corrected claim, not an appeal.
The revenue codes at a glance
| Code | Meaning | Typical use |
|---|---|---|
| 1001 | Residential treatment, psychiatric | Mental health and eating disorder residential, per day |
| 1002 | Residential treatment, chemical dependency | SUD residential, and residential detox at some payers |
| 0905 | Intensive outpatient, psychiatric | Mental health IOP, per day |
| 0906 | Intensive outpatient, chemical dependency | SUD IOP, per day |
| 0912 | Partial hospitalization, less intensive | PHP, when the contract defines a lower tier |
| 0913 | Partial hospitalization, intensive | PHP, the full-day tier at most payers |
| 0116, 0126, 0136, 0156 | Room and board, detoxification (private, two-bed, three and four bed, ward) | Inpatient detox days |
| 0114, 0124, 0134, 0154 | Room and board, psychiatric (same room types) | Inpatient psychiatric days |
The National Uniform Billing Committee (NUBC) maintains the official revenue code set. Meanings above follow the list published by Noridian, a Medicare administrative contractor.
HCPCS codes payers pair with them
Many commercial payers want a HCPCS code on the line next to the revenue code. Which one depends on the payer's billing guide and your contract. These pairings come from published payer guides.
| Level of care | Revenue code | HCPCS often requested | Where we saw it |
|---|---|---|---|
| SUD IOP | 0906 | H0015: alcohol and drug IOP, at least 3 hours a day and 3 days a week | Evernorth, BCBS of Mississippi |
| Mental health IOP | 0905 | S9480: intensive outpatient psychiatric, per diem | Evernorth, BCBS of Mississippi |
| PHP | 0912 or 0913 | H0035: mental health partial hospitalization, under 24 hours. Some payers accept S0201 | Evernorth (S0201 as an alternate), Point32Health |
| Residential | 1001 or 1002 | Often none. Where asked: H0018 (short-term) or H0019 (long-term) | Evernorth lists no HCPCS for residential |
| Residential detox | 1002 | H0010 (sub-acute) or H0011 (acute) | Point32Health |
| Inpatient detox | 0126 (or 0116, 0136, 0146, 0156) | None listed | Evernorth |
HCPCS meanings are from the CMS October 2026 HCPCS file. CMS marks these H and S codes as not payable by Medicare; commercial payers and Medicaid programs set their own rules for them.
Units and per diem basics
- Residential, PHP and IOP are usually billed per day: one line and one unit for each date of service.
- Some payers count PHP in half days. Point32Health, for example, bills H0035 as one unit for a half day and two for a full day. Read the guide before you set units.
- Ask whether the payer accepts interim bills for long stays, or wants one claim per episode.
- Check what the per diem includes. Labs, therapy or room and board billed on separate lines may deny as bundled.
Denial pitfalls and the codes you will see
| What went wrong | Codes you may see | First fix |
|---|---|---|
| Level billed does not match the authorization (for example 1002 billed, PHP authorized) | CO-197, CO-198, N54 | Check the auth. Billing error: corrected claim. Real step-down: request the right auth |
| HCPCS missing or wrong on an IOP or PHP line | CO-16 with M51, CO-4 | Corrected claim with the code the guide asks for |
| More days billed than authorized | CO-198, N362 | Request added days or a retro review; appeal with notes if denied |
| Separate lines for services the per diem includes | CO-97 | Check the contract; remove or accept |
| Diagnosis does not fit the level of care | CO-11 | Fix diagnosis order on a corrected claim, or appeal with records |
| Plan excludes the level of care | CO-96, CO-204 | Verify benefits; ask whether a parity argument applies |
Corrected claims go out with frequency code 7 and the payer's original claim number (REF*F8 on the 837I). Without the original number, the payer cannot tell which claim to replace and may deny it as a duplicate. Look up any code in our free denial code lookup.
Frequently asked questions
What is revenue code 1002?
Residential treatment, chemical dependency. It is a per day accommodation code for substance use disorder residential programs. See the revenue code 1002 page.
Does revenue code 1002 need a HCPCS code?
It depends on the payer. Evernorth's billing resource lists no HCPCS for residential. Point32Health pairs 1002 with H0010 or H0011 for detox levels. Check the payer's current guide and your contract.
What is the difference between 0912 and 0913?
Both are partial hospitalization. 0912 is the less intensive tier and 0913 the intensive tier. Your contract usually defines which one applies to your program.
Can I bill S9480 with revenue code 0906?
S9480 describes intensive outpatient psychiatric services, and published guides pair it with 0905. SUD IOP is usually 0906 with H0015. Mixing them can trigger a coding denial.
Sources
- Noridian Healthcare Solutions (Medicare contractor), Revenue codes (opens in a new tab)
- Novitas Solutions (Medicare contractor), Intensive outpatient program billing requirements for institutional providers (opens in a new tab)
- 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)
- X12, Claim Adjustment Reason Codes (official list) (opens in a new tab)
- Stedi, Resubmit or cancel claims (opens in a new tab)
Last reviewed October 2026. Payer rules change; check the source before you file.
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