Summary & Overview
HCPCS H0041: Foster Care, Child, Non-Therapeutic, Per Diem
HCPCS Level II code H0041 denotes a per diem payment for non-therapeutic foster care placement of a child. This code is used to bill for daily custodial and maintenance services provided to children placed in foster care settings where the primary service is not therapeutic treatment. Nationally, H0041 matters because it ties into public and commercial payer arrangements for placement costs, impacts program budgeting for child welfare and behavioral health systems, and informs claims processing for per diem foster care arrangements.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of how H0041 is used in billing for foster care placements, typical sites of service, and the role of the code in payer contracting and reimbursement flows. The publication summarizes common modifiers and related billing considerations (where available), outlines what benchmarks and policy changes influence the use of this code, and provides clinical and administrative context relevant to payers, managed care organizations, and providers involved in child placement services. Data not available in the input is indicated where applicable.
Billing Code Overview
HCPCS Level II code H0041 describes foster care, child, non-therapeutic, per diem services. This code represents daily per diem payments for placement and basic maintenance of a child in foster care where the service is non-therapeutic in nature.
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Service type: Foster care, child, non-therapeutic, per diem
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Typical site of service: Out-of-home foster care placement settings (non-therapeutic custodial care)
Clinical & Coding Specifications
Clinical Context
A typical patient is a child placed into foster care who requires daily non-therapeutic room and board services billed on a per diem basis. The placement is arranged by a child welfare agency or court order when a minor cannot safely remain in the home of origin. Clinical workflow includes intake by the foster care provider, verification of placement authorization from the referring agency, completion of demographic and eligibility documentation, daily supervision and basic nursing observation as needed, coordination of routine primary care and vaccinations, facilitation of school enrollment, and periodic reporting to the placing agency. Billing occurs per diem using the foster care non-therapeutic rate while the child remains in placement; clinical encounters for acute or chronic medical conditions are billed separately under appropriate medical or behavioral health codes. Typical sites of service are licensed foster homes, group homes providing non-therapeutic care, and residential foster care facilities. Common payors include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare depending on placement and eligibility, with authorizations or placement agreements required before billing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When unusually high level of effort or atypical work associated with administrative or oversight responsibilities for placement is documented |