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    v1.0.28
    OpenPayerBilling CodesAlcohol and Drug Abuse TreatmentHCPCS hcpcs-h2017-psychosocial-rehabilitation-15-minutes
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    HCPCS H2017: Psychosocial Rehabilitation Services, 15 Minutes

    Commercial payers pay $23 on average nationally for this procedure.

    HCPCS Level II code H2017 describes psychosocial rehabilitation services provided in 15-minute units, a structured therapeutic service focused on skill-building, community integration, and functional recovery for individuals with serious mental health conditions; the service type is psychosocial rehabilitation and the typical site of service is outpatient behavioral health or community-based settings where clinicians deliver time-based therapeutic interventions to improve daily living and social functioning.

    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

    Commercial reimbursement for HCPCS H2017 centers around BUCA’s average commercial rate of $23.5, with notable divergence among major national carriers. Cigna and UnitedHealth Group sit higher in central tendency — Cigna’s median is $32.2 and UnitedHealth Group’s median is $32.5 — while Aetna’s center is substantially lower at $7.0 and Blue Cross Blue Shield is more variable around its median of $14.3. These differences highlight a wide spread of payer strategies for this behavioral health service.

    Examining dispersion (P75 minus P25) to gauge variability, Blue Cross Blue Shield shows the widest interquartile spread at $19.4 ($29.8 − $9.4), indicating heterogeneous contract levels. UnitedHealth Group follows with a spread of $36.0 ($52.0 − $14.4), which is actually the largest absolute IQR among listed payers; Cigna’s spread is $0.0 ($32.2 − $32.2), the tightest, and Aetna’s spread is $2.9 ($7.0 − $4.1), also relatively tight. BUCA’s quartiles ($13.9, $20.1, $30.2) position the average commercial market between the low Aetna and higher Cigna/UnitedHealth Group clusters.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 28-year-old patient with a history of Major depressive disorder (F32.9) and generalized anxiety disorder (F41.1) is referred for psychosocial rehabilitation to restore community functioning after a psychiatric hospitalization. The patient attends outpatient psychosocial rehabilitation sessions billed as H2017 in 15-minute units. Typical workflow: intake assessment by a licensed clinician to identify functional goals (social skills, daily living, vocational readiness); development of an individualized rehabilitation plan; scheduled 15-minute direct service contacts for skill-building, community reintegration support, group coaching, or one-on-one therapeutic activities delivered by a Rehabilitation Counselor (225C00000X) or Recreation Therapist (225800000X); documentation of time-based interventions, progress toward goals, and any medical necessity supporting continued services; periodic interdisciplinary team review and coordination with prescribers or case management as needed. Services typically occur in outpatient behavioral health clinics, community mental health centers, or structured day programs. Billing uses H2017 per 15 minutes, with appropriate modifiers applied for unusual circumstances (e.g., increased procedural services, reduced services, telehealth).

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    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…
    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…
    95Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim…- Use modifier 95 to indicate a service was furnished via synchronous, real‑time audiovisual telehealth (a live audio‑video conference between patient and provider) rather than in‑person. - Pair…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    225C00000XRehabilitation CounselorAn individual trained and educated in a systematic process of assisting persons with physical, mental, developmental, cognitive, and emotional disabil…
    225800000XRecreation TherapistA recreation therapist uses recreational activities for intervention in some physical, social or emotional behavior to bring about a desired change in…
    207RI0001XClinical & Laboratory Immunology (Internal Medicine) PhysicianAn internal medicine physician who specializes in clinical and laboratory immunology disease management.
    1835N0905XNuclear PharmacistA licensed pharmacist who has demonstrated specialized knowledge and skill in procurement, compounding, quality control testing, dispensing, distribut…
    152W00000XOptometristDoctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injurie…
    364SG0600XGerontology Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
    207RH0005XHypertension Specialist PhysicianA Hypertension Specialist is a physician who concentrates on all aspects of the diagnosis and treatment of hypertension.
    207QS0010XSports Medicine (Family Medicine) PhysicianA family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of hea…

    Related Payer Policy Updates

    Specialty: Home Health & Hospice1 / 3

    10 rows

    PolicyPayerEffective Date
    Home Health, Skilled, and Custodial Care Services (for Idaho Only)UnitedHealthcare2026-08-01
    Private Duty Nursing ServicesColorado Rocky Mountain Health Plans2026-08-01
    Private Duty Nursing Services (for Florida Only)Colorado Rocky Mountain Health Plans2026-08-01
    Private Duty Nursing Services (for New Jersey Only)UnitedHealthcare2026-08-01
    Private Duty Nursing Services (for Kentucky Only)UnitedHealthcare2026-08-01
    Private Duty Nursing Services (for New Mexico Only)UnitedHealthcare2026-08-01
    Private Duty Nursing Services (for Kansas Only)UnitedHealthcare2026-08-01
    Private Duty Nursing ServicesColorado Rocky Mountain Health Plans2026-08-01
    Home Health, Skilled, and Custodial Care Services (for Ohio Only)UnitedHealthcare2026-08-01
    Home Health, Skilled, and Custodial Care ServicesColorado Rocky Mountain Health Plans2026-07-01

    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-H0009-ACUTE-DETOXIFICATION-HOSPITAL-INPATIENT

    HCPCS Level II H0009: Acute Detoxification, Hospital Inpatient

    HCPCS-H0010-SUB-ACUTE-RESIDENTIAL-DETOXIFICATION

    HCPCS H0010: Sub-Acute Detoxification, Residential 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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    H2018Psychosocial rehabilitation services, per diemOften used as an alternative daily rate when services are furnished as a full-day program rather than unit-based 15-minute H2017 billing.