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    v1.0.28
    OpenPayerBilling CodesAlcohol and Drug Abuse TreatmentHCPCS hcpcs-h0009-acute-detoxification-hospital-inpatient
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    HCPCS Level II H0009: Acute Detoxification, Hospital Inpatient

    Commercial payers pay $241 on average nationally for this procedure.

    HCPCS Level II code H0009 describes acute alcohol and/or drug detoxification services delivered in a hospital inpatient setting, indicating medically managed withdrawal care including stabilization and monitoring for patients experiencing acute substance withdrawal; the service type is acute detoxification and the typical site of service is hospital inpatient.

    For related coverage guidance, see recent payer policy updates: Home Health, Skilled, and Custodial Care Services (for Idaho Only), Private Duty Nursing Services (for Florida Only), Private Duty Nursing Services.

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    National Reimbursement Benchmarks

    Commercial rates for HCPCS H0009 vary notably across national payers with BUCA serving as an average-commercial reference at $240.9. Blue Cross Blue Shield shows the highest central tendency with a median of $335.3 and a wide interquartile spread, while Aetna and Cigna present lower medians near $25.9 and $44.8 respectively. UnitedHealth Group clusters tightly around a median of $45.5, and Cigna sits close by, indicating a cluster of payers in the lower mid-range relative to BUCA.

    Measuring dispersion by the IQR (P75 minus P25) highlights differences in rate volatility: Blue Cross Blue Shield has the widest IQR at $275.4 (P75 $513.8 minus P25 $324.0), indicating substantial variability among its allowed amounts. Aetna’s IQR is $229.2 (P75 $254.2 minus P25 $25.0), also large, while UnitedHealth Group is the tightest with an IQR of $22.8 (P75 $55.3 minus P25 $32.5), followed by Cigna with an IQR of $22.4 (P75 $54.4 minus P25 $32.0).

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 42-year-old patient is admitted to a medical-surgical inpatient unit after presenting to the emergency department with tremors, diaphoresis, agitation, and nausea 24 hours after heavy alcohol use. Emergency clinicians document alcohol dependence with withdrawal and place the patient on a monitored detoxification pathway requiring frequent nursing assessments, symptom-triggered benzodiazepine dosing, intravenous fluids, electrolyte replacement, and medical supervision overnight. Psychiatry consults for evaluation of readiness for ongoing addiction treatment and social work coordinates a disposition plan. The hospital documents acute medical management of withdrawal, continuous nursing observation, medication administration for withdrawal symptoms, and an inpatient order set consistent with acute detoxification.

    Typical clinical workflow:

    • Patient triage and medical stabilization in ED.

    • Admission to inpatient hospital detox unit or monitored medical floor under the admitting hospitalist or internist.

    • Baseline history, physical exam, and relevant labs (electrolytes, liver panel, CBC, toxicology) performed.

    • Implementation of a standardized withdrawal management protocol (symptom-triggered or fixed-schedule pharmacotherapy), intravenous access and fluids as needed, and frequent nursing reassessments.

    • Consults placed (addiction psychiatry or psychology, addiction counselor, social work) for behavioral health assessment and discharge planning.

    • Daily documentation of withdrawal severity, medications administered, vital signs, and readiness for step-down to sub-acute services or referral to residential addiction program.

    This service is billed using H0009 for acute inpatient detoxification when the primary service is medical management of withdrawal in a hospital setting.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    54Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    56Modifier ‑56 indicates the reporting provider furnished only the preoperative management for a surgical procedure and did not perform the intraoperative or postoperative care. It is used in…- Use Modifier -56 when a provider performs only the preoperative management in a split‑care situation (one physician manages preop care while a different physician performs the intraoperative…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    101YA0400XAddiction (Substance Use Disorder) CounselorBehavioral Health & Social Service Providers · Counselor
    103TP2701XGroup Psychotherapy PsychologistA psychologist who specializes in group psychology and group psychotherapy that is an evidenced-based specialty that prepares group leaders to identif…
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    207RB0002XObesity Medicine (Internal Medicine) PhysicianA physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the ge…
    2083X0100XOccupational Medicine PhysicianOccupational medicine focuses on the health of workers, including the ability to perform work; the physical, chemical, biological, and social environm…
    172P00000XNaprapathNaprapathy means a branch of medicine that focuses on the evaluation and treatment of neuron-muscular conditions. Doctors of naprapathy are connectiv…
    363LP2300XPrimary Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner
    363LW0102XWomen's Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner

    Related ICD-10-CM Codes

    29 rows

    ICD-10-CM CodeDescription
    F10.10Alcohol abuse, uncomplicated
    F10.129Alcohol abuse with intoxication, unspecified
    F10.20Alcohol dependence, uncomplicated
    F10.239Alcohol dependence with withdrawal, unspecified
    F10.24Alcohol dependence with alcohol-induced mood disorder
    F11.129Opioid abuse with intoxication, unspecified
    F11.20Opioid dependence, uncomplicated
    F11.23Opioid dependence with withdrawal
    F12.129Cannabis abuse with intoxication, unspecified
    F12.20Cannabis dependence, uncomplicated

    Showing 1–10 of 29

    Related Payer Policy Updates

    Specialty: Home Health & Hospice1 / 3

    9 rows

    PolicyPayerEffective Date
    Home Health, Skilled, and Custodial Care Services (for Idaho Only)UnitedHealthcare2026-08-01
    Private Duty Nursing Services (for Florida Only)Colorado Rocky Mountain Health Plans2026-08-01
    Private Duty Nursing ServicesColorado Rocky Mountain Health Plans2026-08-01
    Private Duty Nursing Services (for New Mexico Only)UnitedHealthcare2026-08-01
    Private Duty Nursing Services (for New Jersey Only)UnitedHealthcare2026-08-01
    Private Duty Nursing Services (for Kentucky Only)UnitedHealthcare2026-08-01
    Private Duty Nursing ServicesColorado Rocky Mountain Health Plans2026-08-01
    Private Duty Nursing Services (for Kansas Only)UnitedHealthcare2026-08-01
    Home Health, Skilled, and Custodial Care Services (for Ohio Only)UnitedHealthcare2026-08-01

    Related Codes

    HCPCS-H0001-ALCOHOL-DRUG-ASSESSMENT-OUTPATIENT

    HCPCS H0001: Alcohol and/or Drug Assessment

    HCPCS-H0002-BEHAVIORAL-HEALTH-SCREENING-ADMISSION-ELIGIBILITY

    HCPCS H0002: Behavioral Health Screening for Treatment Admission

    HCPCS-H0003-ALCOHOL-DRUG-SCREENING-LAB-ANALYSIS

    HCPCS Level II H0003: Alcohol and/or Drug Screening Laboratory Analysis

    HCPCS-H0004-BEHAVIORAL-HEALTH-COUNSELING-15-MINUTE

    HCPCS H0004: Behavioral Health Counseling and Therapy, per 15 Minutes

    HCPCS-H0005-GROUP-COUNSELING-SUBSTANCE-USE-CLINICIAN

    HCPCS H0005: Alcohol and/or Drug Group Counseling by Clinician

    HCPCS-H0006-ALCOHOL-DRUG-CASE-MANAGEMENT

    HCPCS H0006: Alcohol and/or Drug Services, Case Management

    HCPCS-H0007-ALCOHOL-DRUG-CRISIS-INTERVENTION-OUTPATIENT

    HCPCS H0007: Alcohol and/or Drug Crisis Intervention (Outpatient)

    HCPCS-H0008-SUB-ACUTE-DETOXIFICATION-HOSPITAL-INPATIENT

    HCPCS H0008: Alcohol and/or Drug Sub-Acute Detoxification (Inpatient)

    HCPCS-H0010-SUB-ACUTE-RESIDENTIAL-DETOXIFICATION

    HCPCS H0010: Sub-Acute Detoxification, Residential Inpatient

    HCPCS-H0011-ACUTE-DETOXIFICATION-RESIDENTIAL-INPATIENT

    HCPCS H0011: Acute Detoxification, Residential Addiction Inpatient

    Showing 1–10 of 93

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    H0008Alcohol and/or drug services; sub-acute detoxification (hospital inpatient)Used when the level of care provided is sub-acute rather than acute medical detox; often follows or precedes H0009 if level of care changes.
    H0010Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient)Used when the patient is transferred to or from a residential addiction program for sub-acute detoxification and ongoing monitoring; coordinates care in continuum from inpatient acute medical detox (H0009).