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    v1.0.28
    OpenPayerBilling CodesAlcohol and Drug Abuse TreatmentHCPCS hcpcs-h2019-therapeutic-behavioral-services-15-min
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    HCPCS H2019: Therapeutic Behavioral Services, 15-Minute Units

    HCPCS Level II code H2019 describes therapeutic behavioral services delivered in 15-minute units, typically provided as individualized behavioral health therapy focused on skill-building, stabilization, or behavior management; the service type is behavioral health therapy and the typical site of service is outpatient clinic or community-based settings where short-interval, direct therapeutic interventions are delivered.

    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 school-aged child with a primary diagnosis of autism spectrum disorder receives billed therapeutic behavioral services in 15-minute increments to address maladaptive behaviors that interfere with learning and safety. The clinical workflow begins with a behavioral assessment and individualized treatment plan established by a licensed behavioral health clinician (for example, a Board Certified Behavior Analyst or licensed clinical social worker) in collaboration with the child’s parents and school staff. Sessions are scheduled in community settings (home, school, clinic) or via telehealth when permitted. Each 15-minute unit of H2019 documents face-to-face direct therapeutic behavioral intervention focused on skill acquisition, behavior reduction strategies, and caregiver training. Progress notes include start/stop times, objective behavioral targets, interventions used (for example, antecedent modification, prompting, reinforcement), patient response, and coordination with other providers. Ongoing reimbursement requires linkage of billed units to the individualized plan of care, measurable goals, and periodic reassessment.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97151Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of analysis, assessment and reportPerformed before H2019 to establish behavioral baselines and develop a plan of care.
    97153Adaptive behavior treatment by protocol, administered by technician under the direction of a qualified professional, face-to-face, each 15 minutesCommonly provided alongside H2019 when technician-delivered ABA interventions are used; documents protocolized treatment units.
    97155Adaptive behavior treatment with protocol modification, administered by a physician or other qualified health care professional, face-to-face, each 15 minutesUsed when the supervising clinician modifies treatment protocols during H2019 services.
    90832Psychotherapy, 30 minutes with patient and/or family memberMay be used in the care plan for psychotherapy components that are longer, complementing the short-interval behavioral units billed with H2019.
    96127Brief emotional/behavioral assessment (e.g., standardized instruments) with scoring and documentation, per standardized instrumentUsed for periodic measurement of outcomes that support continued medical necessity for H2019 services.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    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…
    95Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim…- Use modifier 95 to indicate a service was furnished via synchronous, real‑time audiovisual telehealth (a live audio‑video conference between patient and provider) rather than in‑person. - Pair…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    103K00000XBehavior AnalystA behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential …
    101Y00000XCounselorA provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and …
    106H00000XMarriage & Family TherapistA marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related menta…
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    367A00000XAdvanced Practice MidwifeAdvanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproduc…
    2080N0001XNeonatal-Perinatal Medicine PhysicianA pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with…
    225XP0200XPediatric Occupational TherapistOccupational therapists provide services to infants, toddlers and children who have or who are at risk for developmental delays or disabilities. Occup…
    332H00000XEyewear SupplierAn organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

    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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