HCPCS H0019: Behavioral Health Long-Term Residential, Per Diem
HCPCS Level II code H0019 represents behavioral health long-term residential services (non-medical, non-acute care in a residential treatment program with stays typically longer than 30 days), billed per diem; the service type is long-term residential behavioral health treatment and the typical site of service is a residential treatment program (non-acute, non-medical) where room and board are not included.
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).
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National Reimbursement Benchmarks
National commercial rates for HCPCS H0019 center around BUCA’s average commercial rate of $160.20, with notable dispersion among major carriers. Blue Cross Blue Shield shows the largest spread between its 75th and 25th percentiles (range $120.9), reflecting substantial upper-end variability, while Cigna’s 75th–25th interquartile range is tight ($6.8), indicating concentrated pricing near lower medians. UnitedHealth Group and Aetna have moderate spreads of $148.2 and $10.0 respectively, signaling different variability profiles across national contracts.
Price centrality differs by payer: UnitedHealth Group’s median sits high at $208.8 contrasting with Cigna’s low median of $25.3, with BUCA’s mean of $160.20 near the market mid-point. Payer-specific maxima further illustrate upper-tail divergence (Blue Cross Blue Shield up to $497.10, UnitedHealth Group up to $363.10, Cigna up to $381.60), underscoring heterogeneous commercial reimbursement for H0019 across carriers.