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    v1.0.30
    OpenPayerBilling CodesAlcohol and Drug Abuse TreatmentHCPCS hcpcs-h0006-alcohol-drug-case-management
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    HCPCS H0006: Alcohol and/or Drug Services, Case Management

    HCPCS Level II code H0006 describes alcohol and/or drug services: case management, a care coordination service that links individuals with substance use disorders to clinical, social, and community supports; service type is behavioral health case management, typically provided in outpatient behavioral health clinics, community treatment programs, or via community-based case management visits to coordinate care, referrals, and service planning.

    For related coverage guidance, see recent payer policy updates: Adult Foster Care, Group Adult Foster Care Clinical Coverage Criteria, Home Health Care Payment Policy.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 38-year-old patient with alcohol use disorder and unstable housing is referred to outpatient behavioral health services after discharge from the emergency department for intoxication. The patient has difficulty attending appointments, lacks coordination of community resources, and needs linkage to housing, employment support, medication-assisted treatment, and benefits enrollment. A licensed clinical case manager (often a licensed clinical social worker, substance use disorder counselor, or case management specialist) performs an initial comprehensive needs assessment, develops a written care plan, coordinates referrals to detoxification or medication-assisted treatment, communicates with primary care and behavioral health providers, assists with scheduling, monitors adherence to treatment goals, and documents progress in the electronic health record. Services billed under H0006 are typically episodic and may include outreach in community settings, phone contacts, home visits, and coordination with legal or social services. Typical sites of service include outpatient behavioral health clinics, community-based treatment programs, residential treatment facilities, and patient homes or community locations when outreach is required. Workflow steps: initial referral and intake, assessment and care plan development, active case management contacts (in-person or telephonic), coordination of services (referrals, authorizations), periodic reassessment, discharge planning when goals met, and transition to ongoing outpatient or recovery supports.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    90833Psychotherapy, 30 minutes with patient when performed with an evaluation and management serviceMay be performed alongside H0006 when psychotherapy is delivered during an E/M visit; documents therapeutic contact separate from case management.
    99358Prolonged service without direct patient contact, first hourUsed for extended care coordination activities (telephone outreach, review of records) that are not face-to-face and occur before/after standard visits.
    99487Complex chronic care management services, first 60 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar monthApplied when case management addresses complex chronic conditions including substance use disorder as part of multidisciplinary chronic care management.
    99490Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar monthMay complement H0006 when addressing medical comorbidities and ongoing care coordination.
    90791Psychiatric diagnostic evaluation (no medical services)Performed at intake to establish psychiatric diagnoses and treatment planning that inform the H0006 case management plan.
    G2012Brief communication technology-based service, e.g., telephone or internetUsed for brief check-ins or telephonic outreach supporting case management activities when payer accepts this service in coordination.

    Related Modifiers

    7 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…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    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 Code
    101YM0800X
    251B00000X
    103T00000X
    367500000X
    172P00000X
    163WC1600X
    163WL0100X
    310400000X

    Related Payer Policy Updates

    Specialty: Home Health & Hospice1 / 3

    10 rows

    PolicyPayerEffective Date
    Adult Foster Carefallon_community_health_plan_inc2027-01-27
    Group Adult Foster Care Clinical Coverage Criteriafallon_community_health_plan_inc2027-01-01
    Home Health Care Payment Policyfallon_community_health_plan_inc2026-12-01
    Private Duty Nursing in the Home SettingAnthem2026-10-01
    Home Health, Skilled, and Custodial Care Services (for Nebraska Only)UnitedHealthcare2026-10-01
    Home Health, Skilled, and Custodial Care Services (for Tennessee Only)UnitedHealthcare2026-10-01
    Home Health, Skilled, and Custodial Care Services (for Kansas Only)UnitedHealthcare2026-09-01
    Private Duty Nursing Services (for Nebraska Only)UnitedHealthcare2026-09-01
    Home Health, Skilled, and Custodial Care Services (for New Jersey Only)UnitedHealthcare2026-09-01
    Home Health, Skilled, and Custodial Care Services (for Idaho 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-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

    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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