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

HCPCS Level II code H0006 designates alcohol and/or drug services for case management, a critical component of the care continuum for individuals with substance use disorders. Case management services coordinate treatment plans, connect patients to community and medical resources, and help manage transitions across care settings. Nationally, effective case management supports engagement in treatment, reduces gaps in care, and can lower downstream acute care utilization.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of how H0006 is used across settings, payer coverage patterns, common billing practices, and benchmarks where available. The publication also outlines clinical context for when case management is applicable and summarizes policy considerations relevant to payer reimbursement and documentation.

The report is intended for billing managers, behavioral health program leaders, and policy analysts seeking concise, national-level guidance on the role and billing context of H0006. Data not available in the input will be noted explicitly in specific sections.

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Billing Code Overview

HCPCS Level II code H0006 represents alcohol and/or drug services; case management. This service involves coordination of care for individuals with substance use disorders, including development and monitoring of service plans, linkage to treatment and social supports, and ongoing communication with providers and community resources.

Service Type: Case management for substance use disorder treatment

Typical Site of Service: Behavioral health clinics, outpatient substance use treatment programs, community-based settings, and integrated behavioral health practices

Data not available in the input.

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

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Billing Code Overview

Service Type: Case management for substance use disorder treatment

Typical Site of Service: Behavioral health clinics, outpatient substance use treatment programs, community-based settings, and integrated behavioral health practices

Data not available in the input.

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.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased Procedural Services	Use when case management requires substantially greater work than typical (documentation must support increased complexity/time).
`23`	Unusual Anesthesia	Rarely applicable; used if an unusual circumstance requires anesthesia during a procedure linked to substance use care (uncommon for `H0006`).
`52`	Reduced Services	Use when case management service was partially provided or curtailed and a reduced service is appropriate.
`53`	Discontinued Procedure	Use when case management engagement was initiated but discontinued due to patient or system factors prior to completion.
`59`	Distinct Procedural Service	Use when `H0006` is a separate, distinct service from other behavioral health services provided the same day (document distinctness).
`62`	Two Surgeons	Not typically applicable; included only for completeness when multiple providers share case management roles (rare).
`95`	Synchronous Telemedicine Service Rendered via Real-Time Interactive Audio and Video	Use when case management is delivered via live video conferencing.
`AS`	Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Assist at Surgery	Not typically applicable to `H0006` but used when advanced practice clinicians assist in related procedures.
`QX`	CRNA Service: With Medical Direction by a Physician	Not applicable to standard case management; included only if anesthesia services are billed in conjunction with other care.
`QY`	Medical Direction of One CRNA by an Anesthesiologist	Same limited applicability as `QX`.
`CO`	Routine Home Health Care	Use when coordination involves certified home health services; billers may use to indicate payer-specific arrangements where applicable.
`CQ`	Service Provided by a Resident Without Attending Physician Present	Use when a supervised resident provides case management activities in teaching settings and billing rules permit.
`TF`	Technical Component Exempt from Certain Penalties	Rarely used for `H0006`; included when specific payer rules require technical component designation.

Taxonomy Code	Specialty	Notes
1041S0000X	Clinical Social Worker	Common provider performing `H0006` case management and care coordination.
101YM0800X	Substance Abuse and Behavioral Health Counselor	Frequently provides case management and linkage to addiction treatment resources.
251B00000X	Psychologist	May coordinate care and provide integrated behavioral health planning.
103T00000X	Licensed Professional Counselor	Provides ongoing coordination, counseling linkage, and resource navigation.
367500000X	Case Manager	Specialist focused on service coordination, eligibility determination, and community referrals.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`F10.20`	Alcohol dependence, uncomplicated	Common primary diagnosis driving case management for linkage to treatment, relapse prevention, and community supports.
`F10.21`	Alcohol dependence, in remission	Relevant when managing transition to recovery supports and monitoring for relapse.
`F11.20`	Opioid dependence, uncomplicated	Frequent diagnosis requiring care coordination for medication-assisted treatment, naloxone access, and social services.
`F11.21`	Opioid dependence, in remission	Applicable for monitoring recovery supports and ongoing resource linkage.
`F12.20`	Cannabis dependence, uncomplicated	May require coordination of psychosocial interventions and outpatient services.
`F19.20`	Other psychoactive substance dependence, uncomplicated	Covers stimulant or polysubstance dependence needing integrated case management.
`Z59.0`	Homelessness	Social determinant frequently encountered that necessitates intensive case management for housing and benefits linkage.
`Z63.5`	Disruption of family by separation and divorce	Psychosocial stressor relevant to care planning and support linkage.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`90833`	Psychotherapy, 30 minutes with patient when performed with an evaluation and management service	May be performed alongside `H0006` when psychotherapy is delivered during an E/M visit; documents therapeutic contact separate from case management.
`99358`	Prolonged service without direct patient contact, first hour	Used for extended care coordination activities (telephone outreach, review of records) that are not face-to-face and occur before/after standard visits.
`99487`	Complex chronic care management services, first 60 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month	Applied when case management addresses complex chronic conditions including substance use disorder as part of multidisciplinary chronic care management.
`99490`	Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month	May complement `H0006` when addressing medical comorbidities and ongoing care coordination.
`90791`	Psychiatric diagnostic evaluation (no medical services)	Performed at intake to establish psychiatric diagnoses and treatment planning that inform the `H0006` case management plan.
`G2012`	Brief communication technology-based service, e.g., telephone or internet	Used for brief check-ins or telephonic outreach supporting case management activities when payer accepts this service in coordination.

HCPCS H0001: Alcohol and/or Drug Assessment

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

HCPCS H0002: Behavioral Health Screening for Admission to Treatment Program

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

HCPCS H0003: Alcohol and/or Drug Screening, Laboratory Analysis

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

HCPCS H0004: Behavioral Health Counseling and Therapy, 15 Minutes

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

HCPCS H0005: Alcohol/Drug Group Counseling by a 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: Sub-acute Detoxification, Hospital Inpatient

HCPCS-H0009-ACUTE-DETOXIFICATION-HOSPITAL-INPATIENT

HCPCS H0009: Alcohol and/or Drug Services, Acute Detoxification (Hospital Inpatient)

HCPCS-H0010-SUB-ACUTE-RESIDENTIAL-DETOXIFICATION

HCPCS H0010: Sub-Acute Residential Detoxification Services

HCPCS-H0011-ACUTE-DETOXIFICATION-RESIDENTIAL-INPATIENT

HCPCS H0011: Acute Detoxification, Residential Inpatient

Showing 1–10 of 93

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`22`	Increased Procedural Services	Use when case management requires substantially greater work than typical (documentation must support increased complexity/time).
`23`	Unusual Anesthesia	Rarely applicable; used if an unusual circumstance requires anesthesia during a procedure linked to substance use care (uncommon for `H0006`).
`52`	Reduced Services	Use when case management service was partially provided or curtailed and a reduced service is appropriate.
`53`	Discontinued Procedure	Use when case management engagement was initiated but discontinued due to patient or system factors prior to completion.
`59`	Distinct Procedural Service	Use when `H0006` is a separate, distinct service from other behavioral health services provided the same day (document distinctness).
`62`	Two Surgeons	Not typically applicable; included only for completeness when multiple providers share case management roles (rare).
`95`	Synchronous Telemedicine Service Rendered via Real-Time Interactive Audio and Video	Use when case management is delivered via live video conferencing.
`AS`	Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Assist at Surgery	Not typically applicable to `H0006` but used when advanced practice clinicians assist in related procedures.
`QX`	CRNA Service: With Medical Direction by a Physician	Not applicable to standard case management; included only if anesthesia services are billed in conjunction with other care.
`QY`	Medical Direction of One CRNA by an Anesthesiologist	Same limited applicability as `QX`.
`CO`	Routine Home Health Care	Use when coordination involves certified home health services; billers may use to indicate payer-specific arrangements where applicable.
`CQ`	Service Provided by a Resident Without Attending Physician Present	Use when a supervised resident provides case management activities in teaching settings and billing rules permit.
`TF`	Technical Component Exempt from Certain Penalties	Rarely used for `H0006`; included when specific payer rules require technical component designation.

Taxonomy Code	Specialty	Notes
1041S0000X	Clinical Social Worker	Common provider performing `H0006` case management and care coordination.
101YM0800X	Substance Abuse and Behavioral Health Counselor	Frequently provides case management and linkage to addiction treatment resources.
251B00000X	Psychologist	May coordinate care and provide integrated behavioral health planning.
103T00000X	Licensed Professional Counselor	Provides ongoing coordination, counseling linkage, and resource navigation.
367500000X	Case Manager	Specialist focused on service coordination, eligibility determination, and community referrals.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`F10.20`	Alcohol dependence, uncomplicated	Common primary diagnosis driving case management for linkage to treatment, relapse prevention, and community supports.
`F10.21`	Alcohol dependence, in remission	Relevant when managing transition to recovery supports and monitoring for relapse.
`F11.20`	Opioid dependence, uncomplicated	Frequent diagnosis requiring care coordination for medication-assisted treatment, naloxone access, and social services.
`F11.21`	Opioid dependence, in remission	Applicable for monitoring recovery supports and ongoing resource linkage.
`F12.20`	Cannabis dependence, uncomplicated	May require coordination of psychosocial interventions and outpatient services.
`F19.20`	Other psychoactive substance dependence, uncomplicated	Covers stimulant or polysubstance dependence needing integrated case management.
`Z59.0`	Homelessness	Social determinant frequently encountered that necessitates intensive case management for housing and benefits linkage.
`Z63.5`	Disruption of family by separation and divorce	Psychosocial stressor relevant to care planning and support linkage.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`90833`	Psychotherapy, 30 minutes with patient when performed with an evaluation and management service	May be performed alongside `H0006` when psychotherapy is delivered during an E/M visit; documents therapeutic contact separate from case management.
`99358`	Prolonged service without direct patient contact, first hour	Used for extended care coordination activities (telephone outreach, review of records) that are not face-to-face and occur before/after standard visits.
`99487`	Complex chronic care management services, first 60 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month	Applied when case management addresses complex chronic conditions including substance use disorder as part of multidisciplinary chronic care management.
`99490`	Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month	May complement `H0006` when addressing medical comorbidities and ongoing care coordination.
`90791`	Psychiatric diagnostic evaluation (no medical services)	Performed at intake to establish psychiatric diagnoses and treatment planning that inform the `H0006` case management plan.
`G2012`	Brief communication technology-based service, e.g., telephone or internet	Used for brief check-ins or telephonic outreach supporting case management activities when payer accepts this service in coordination.

HCPCS H0001: Alcohol and/or Drug Assessment

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

HCPCS H0002: Behavioral Health Screening for Admission to Treatment Program

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

HCPCS H0003: Alcohol and/or Drug Screening, Laboratory Analysis

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

HCPCS H0004: Behavioral Health Counseling and Therapy, 15 Minutes

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

HCPCS H0005: Alcohol/Drug Group Counseling by a 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: Sub-acute Detoxification, Hospital Inpatient

HCPCS-H0009-ACUTE-DETOXIFICATION-HOSPITAL-INPATIENT

HCPCS H0009: Alcohol and/or Drug Services, Acute Detoxification (Hospital Inpatient)

HCPCS-H0010-SUB-ACUTE-RESIDENTIAL-DETOXIFICATION

HCPCS H0010: Sub-Acute Residential Detoxification Services

HCPCS-H0011-ACUTE-DETOXIFICATION-RESIDENTIAL-INPATIENT

HCPCS H0011: Acute Detoxification, Residential Inpatient

Showing 1–10 of 93

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

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

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Billing Code Overview

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

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References