HCPCS H0018: Short-Term Residential Behavioral Health, Per Diem
Commercial payers pay $247 on average nationally for this procedure.
HCPCS Level II code H0018 describes per diem billing for short-term residential behavioral health treatment without room and board, a non-hospital residential treatment program focused on active behavioral health services; service type is short-term residential behavioral health care, and the typical site of service is a non-hospital residential treatment facility providing structured, time-limited therapeutic programming.
For related coverage guidance, see recent payer policy updates: Home Health, Skilled, and Custodial Care Services (for Idaho Only), Private Duty Nursing Services, Private Duty Nursing Services (for Florida Only).
Customize your policy alerts
Sign up for hcpcs H0018 policy alerts
Get alerted when payer policies referencing H0018 are released or updated.
Monitor payer policy activity
National Reimbursement Benchmarks
National commercial reimbursement for HCPCS H0018 centers around BUCA’s average commercial benchmark of $247.30, providing a mid-market anchor. Blue Cross Blue Shield (BCBS) and Cigna exhibit higher ceiling flexibility with maximums of $553.50 and $804.80 respectively, while Aetna’s mean is near the market at $274.90 and UnitedHealth Group’s mean sits notably lower at $90.20. These means highlight a wide spread in payer pricing philosophy across commercial contracts.
Dispersion measured as P75 minus P25 is narrowest for Cigna (P75–P25 = $0.00) and Aetna (P75–P25 = $27.00), indicating tight clustering around their midpoints, whereas Blue Cross Blue Shield shows the widest interquartile spread (P75–P25 = $116.10). UnitedHealth Group’s dispersion is $110.65 and BUCA’s interquartile range is $86.10, signaling moderate variability for those payer cohorts.