Summary & Overview
HCPCS Level II H0031: Mental Health Assessment by Non-Physician
Headline: HCPCS Level II code H0031: Mental Health Assessment by Non-Physician
Lead: HCPCS Level II code H0031 denotes a mental health assessment performed by a non-physician clinician, a foundational service in community-based behavioral health care. This code captures the assessment encounter used to evaluate psychiatric symptoms, functioning, and care needs when delivered outside physician-led settings.
What the code represents and why it matters: H0031 documents non-physician-led mental health assessments that inform treatment planning, care coordination, and access to behavioral health services. Nationally, clear use of this code supports tracking of outpatient behavioral health capacity and ensures appropriate service classification in community mental health and similar settings.
Key payers covered: Analysis and guidance address major national commercial payers: Aetna; Blue Cross Blue Shield (BCBS) plans; Cigna Health; and UnitedHealthcare. Coverage policies and billing rules among these payers influence utilization and claims processing for non-physician assessment services.
Overview of reader takeaways: Readers will learn the clinical and billing context for H0031, typical sites of service, common documentation expectations, common associated diagnoses, and how this code relates to closely associated services used in behavioral health workflows. The publication clarifies which encounter this code represents, highlights payor coverage considerations, and presents relevant clinical scenarios where the assessment code is commonly applied.
Data gaps: Service-line metadata is not provided. Data not available in the input.
Billing Code Overview
HCPCS Level II code H0031 describes a mental health assessment provided by a non-physician. The service is classified under Behavioral Health and is typically delivered in a Community Mental Health Center (POS 53). This code documents the assessment encounter itself and is used to record the professional activity of a qualified non-physician clinician conducting an initial or follow-up mental health evaluation.
Clinical & Coding Specifications
Clinical Context
A 29-year-old patient presents to a Community Mental Health Center (POS 53) requesting evaluation for worsening mood and anxiety after recent job loss. The intake is scheduled with a non-physician behavioral health clinician (master's-level mental health counselor) who completes a comprehensive mental health assessment lasting 45–60 minutes. The assessment includes standardized screening instruments, clinical interview covering history of present illness, psychiatric history, substance use, risk assessment, functional status, and summary recommendations for treatment planning. The clinician documents findings, assigns provisional diagnoses, and communicates results to the treatment team for service planning. Telehealth may be used when appropriate with interactive audio and video systems.
Coding Specifications
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HCPCS Level II code
H0031: Mental health assessment, by non-physician. -
Common Modifiers
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GT— Via interactive audio and video telecommunication systems: Use when the assessment is delivered synchronously by interactive audio and video technology. -
HO— Master's degree level: Use to indicate the service was provided by a clinician whose highest qualifying credential is a master’s degree. -
Associated Provider Taxonomies
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— Mental Health Counselor: Providers with this taxonomy typically perform psychotherapy, assessments, and counseling services in behavioral health settings.