HCPCS Level II H0038: Self-Help/Peer Support Services, per 15 minutes
HCPCS Level II code H0038 describes self-help/peer support services billed per 15 minutes, representing time-based peer specialist or peer support interactions used as behavioral health support; service type is peer support/self-help services and the typical site of service is community or outpatient behavioral health settings where peer specialists meet with clients for structured support sessions.
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National Reimbursement Benchmarks
Commercial reimbursement for HCPCS H0038 clusters around the BUCA average of $19.4, with several national payers offering similar mid-teens to low-twenties rates. Blue Cross Blue Shield shows the largest spread, with a P75–P25 range of $18.5, indicating substantial regional or product-level variation, while Aetna is tightly clustered with a range of $1.0 and very low rates near the bottom end of the spectrum. UnitedHealth Group and Cigna both display narrow dispersion—UnitedHealth Group’s P75–P25 range is $0.2 and Cigna’s is effectively $0.0—signaling consistent contracted values across markets for those payers.
Across payers, extreme values are notable: Blue Cross Blue Shield’s max reaches $99.2, far above the BUCA average of $19.4, while Aetna’s max is only $10. The combination of a high BCBS ceiling and tight, consistent levels from UnitedHealth Group and Cigna highlights a market where a single large payer can create substantial upside variability even as other major payers keep rates stable around the BUCA mean.