Summary & Overview
HCPCS Level II H0042: Foster Care, Child, Non-Therapeutic, Monthly
HCPCS Level II code H0042 covers monthly non-therapeutic foster care for a child, representing routine maintenance, supervision, and room-and-board provided in licensed foster homes or residential placements. This code is important nationally because it aligns reimbursement with the ongoing care needs of children placed in foster care, supporting continuity of care and placement stability.
Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical meaning, typical site of service, and payer relevance. The publication outlines how H0042 is used to bill monthly non-therapeutic foster care, summarizes common modifiers applicable to similar HCPCS claims, and describes where the code fits in service lines for child welfare and behavioral health programs.
The content provides benchmarks and policy context relevant to national payers, explains reporting considerations for monthly foster care maintenance, and highlights implications for provider billing workflows and claims processing. Data not included in the input—such as specific payer fee schedules, associated taxonomies, and ICD-10 pairings—is identified as unavailable.
Billing Code Overview
HCPCS Level II code H0042 represents foster care services for children provided on a non-therapeutic basis, billed per month. The service type is foster care maintenance and room-and-board support for a child in a foster placement. The typical site of service is residential or family-based foster care placement, where a child receives non-clinical caregiving, supervision, and daily living supports in a foster home or licensed residential setting.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A child placed in non-therapeutic foster care under the custody of a state child welfare agency receives monthly placement services billed using H0042. Typical scenario: a 7-year-old child removed from the home for safety concerns is placed with a licensed foster family. The foster care agency documents placement initiation, monthly case management contacts, routine oversight, and payments for basic room and board support provided to the foster family. The monthly workflow includes verification of ongoing custody, monthly home visits or virtual checks by a caseworker, documentation of child well-being and education status, coordination with schools and medical providers, and routine administrative activities such as eligibility verification and monthly billing. Providers involved include licensed foster care agencies and child welfare caseworkers who maintain records of placement dates, caregiver licensing, and monthly service attestations required for billing H0042 to public payors and managed care plans such as Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When documentation supports substantially greater administrative effort for the month (rare for ). |