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    v1.0.28
    OpenPayerBilling CodesAlcohol and Drug Abuse TreatmentHCPCS hcpcs-h2018-psychosocial-rehabilitation-per-diem
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    HCPCS H2018: Psychosocial Rehabilitation Services, Per Diem

    HCPCS Level II code H2018 describes psychosocial rehabilitation services provided on a per diem basis, representing a bundled day rate for structured psychosocial rehabilitation treatment; the service type is psychosocial rehabilitation and the typical site of service is an organized outpatient or community-based behavioral health program where individuals receive goal-directed therapeutic activities and skill-building supports over the course of a treatment day.

    For related coverage guidance, see recent payer policy updates: Home Health, Skilled, and Custodial Care Services (for Idaho Only), Private Duty Nursing Services, Private Duty Nursing Services (for Florida Only).

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    Clinical & Coding Specifications

    Clinical Context

    A 28-year-old adult with a diagnosis of schizophrenia resides in a community-based psychosocial rehabilitation program. The patient attends a structured day program at a psychosocial rehabilitation facility five days per week. Services include individualized skill-building, social skills groups, supported employment preparation, medication adherence support, and community integration activities. A multidisciplinary team — including a psychiatric rehabilitation specialist, licensed clinical social worker, vocational counselor, and peer support specialist — conducts an initial intake assessment, develops a person-centered rehabilitation plan, documents daily progress notes, and delivers therapeutic and habilitative activities designed to improve functioning and community tenure. Billing is performed on a per diem basis under H2018 to cover the full day of psychosocial rehabilitation services provided at the program site. Typical workflow: referral and eligibility verification; intake assessment and service planning; daily delivery of group and individual rehabilitation interventions; coordination with prescribers and community resources; daily documentation of attendance, interventions, and progress; periodic service plan review and outcome measurement prior to continuation of per diem billing.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    90791Psychiatric diagnostic evaluation (no medical services)Used at intake to assess psychiatric needs and inform the psychosocial rehabilitation service plan billed under H2018.
    90832Psychotherapy, 30 minutes with patientMay be provided as individual therapy adjunct to per diem services when separate psychotherapy is delivered and billed according to payor rules.
    92507Treatment of speech, language, voice, communication, and/or auditory processing disorder; individualUsed when communication or social skills therapy is required in addition to day program services; may be billed separately if documented.
    97537Community/work reintegration, per 15 minutesUsed for community integration and supported employment activities that complement per diem psychosocial rehab; may be billed when payor allows separate billing.
    G0176Therapeutic procedures to increase functional ability (Medicare hospice)Occasionally used in settings where Medicare requires a different code set for specific habilitative-rehabilitative tasks; included as a related Medicare-level procedure.

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    54Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    101Y00000XCounselorA provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and …
    103T00000XPsychologistA psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, a…
    207VB0002XObesity Medicine (Obstetrics & Gynecology) PhysicianA physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the ge…
    3416S0300XWater AmbulanceTransportation Services · Ambulance
    207VF0040XUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianA subspecialist in Urogynecology and Reconstructive Pelvic Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education …
    175F00000XNaturopathDiagnoses, treats, and cares for patients, using system of practice that bases treatment of physiological functions and abnormal conditions on natural…
    125J00000XDental TherapistA Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the releva…
    261QG0250XGenetics Clinic/CenterAn entity, facility, or distinct part of a facility providing analysis of family history, genetic laboratory testing and analysis, diagnosis of geneti…

    Related Payer Policy Updates

    Specialty: Home Health & Hospice1 / 3

    10 rows

    PolicyPayerEffective Date
    Home Health, Skilled, and Custodial Care Services (for Idaho Only)UnitedHealthcare2026-08-01
    Private Duty Nursing ServicesColorado Rocky Mountain Health Plans2026-08-01
    Private Duty Nursing Services (for Florida Only)Colorado Rocky Mountain Health Plans2026-08-01
    Private Duty Nursing Services (for New Jersey Only)UnitedHealthcare2026-08-01
    Private Duty Nursing Services (for Kentucky Only)UnitedHealthcare2026-08-01
    Private Duty Nursing Services (for New Mexico Only)UnitedHealthcare2026-08-01
    Private Duty Nursing Services (for Kansas Only)UnitedHealthcare2026-08-01
    Private Duty Nursing ServicesColorado Rocky Mountain Health Plans2026-08-01
    Home Health, Skilled, and Custodial Care Services (for Ohio Only)UnitedHealthcare2026-08-01
    Home Health, Skilled, and Custodial Care ServicesColorado Rocky Mountain Health Plans2026-07-01

    Related Codes

    HCPCS-H0001-ALCOHOL-DRUG-ASSESSMENT-OUTPATIENT

    HCPCS H0001: Alcohol and/or Drug Assessment

    HCPCS-H0002-BEHAVIORAL-HEALTH-SCREENING-ADMISSION-ELIGIBILITY

    HCPCS H0002: Behavioral Health Screening for Treatment Admission

    HCPCS-H0003-ALCOHOL-DRUG-SCREENING-LAB-ANALYSIS

    HCPCS Level II H0003: Alcohol and/or Drug Screening Laboratory Analysis

    HCPCS-H0004-BEHAVIORAL-HEALTH-COUNSELING-15-MINUTE

    HCPCS H0004: Behavioral Health Counseling and Therapy, per 15 Minutes

    HCPCS-H0005-GROUP-COUNSELING-SUBSTANCE-USE-CLINICIAN

    HCPCS H0005: Alcohol and/or Drug Group Counseling by Clinician

    HCPCS-H0006-ALCOHOL-DRUG-CASE-MANAGEMENT

    HCPCS H0006: Alcohol and/or Drug Services, Case Management

    HCPCS-H0007-ALCOHOL-DRUG-CRISIS-INTERVENTION-OUTPATIENT

    HCPCS H0007: Alcohol and/or Drug Crisis Intervention (Outpatient)

    HCPCS-H0008-SUB-ACUTE-DETOXIFICATION-HOSPITAL-INPATIENT

    HCPCS H0008: Alcohol and/or Drug Sub-Acute Detoxification (Inpatient)

    HCPCS-H0009-ACUTE-DETOXIFICATION-HOSPITAL-INPATIENT

    HCPCS Level II H0009: Acute Detoxification, Hospital Inpatient

    HCPCS-H0010-SUB-ACUTE-RESIDENTIAL-DETOXIFICATION

    HCPCS H0010: Sub-Acute Detoxification, Residential Inpatient

    Showing 1–10 of 93

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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