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HCPCS H0011: Acute Detoxification, Residential Inpatient
HCPCS Level II code H0011 designates acute detoxification services delivered in a residential addiction program on an inpatient basis. This code captures medically supervised withdrawal management for patients with alcohol or drug dependence who require continuous observation and clinical interventions during the acute detox phase. Nationwide, H0011 is a key billing descriptor for facilities providing intensive early-stage substance use disorder care and is relevant to behavioral health capacity, payer coverage policies, and inpatient utilization patterns.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise overview of coverage considerations across major payers, how H0011 relates to adjacent service codes for sub-acute and ambulatory detoxification, and the common clinical contexts tied to acute withdrawal management. The publication also outlines typical service settings and the clinical diagnoses that commonly accompany acute detoxification claims.
The content is intended to inform revenue cycle teams, behavioral health program directors, and health policy stakeholders about the billing definition, clinical scope, and coding neighbors for H0011. It summarizes what payers commonly recognize for acute residential detoxification and highlights where claims reviewers and administrators should align clinical documentation with the inpatient detoxification service described by the code.
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Billing Code Overview
HCPCS Level II code H0011 represents alcohol and/or drug services for acute detoxification provided in a residential addiction program on an inpatient basis. The service involves medically supervised withdrawal management for patients experiencing acute substance withdrawal that requires continuous monitoring and clinical support.
Service Type: Acute detoxification (residential inpatient addiction program)
Typical Site of Service: Residential addiction treatment facility (inpatient)
National Reimbursement Benchmarks
Commercial pricing for HCPCS H0011 centers around a BUCA average of $227, with meaningful variability across national payers. Blue Cross Blue Shield shows one of the widest interquartile spreads (P75–P25 = $162), indicating broader mid‑range deviation, while Aetna’s IQR is $103, reflecting moderately concentrated mid‑range pricing. UnitedHealth Group has an IQR of $289, the largest spread and the greatest dispersion across the central 50% of its rates. Cigna’s IQR is $160, also relatively wide, and BUCA’s own P75–P25 equals $168, consistent with wide commercial variation overall.
Looking at central tendency, Aetna’s mean of $301.90 and UnitedHealth Group’s mean of $162.10 bracket the market, while Cigna’s low median of $15.20 signals a skew toward very low typical payments for some contracts. Blue Cross Blue Shield’s mean is $244.50. These patterns highlight a market where mid‑market averages coexist with substantial payer‑level dispersion in the central 50% of rates.