HCPCS H2031: Mental Health Clubhouse Services, Per Diem

HCPCS Level II code H2031 describes mental health clubhouse services, per diem, a structured psychosocial rehabilitation and community-based program delivering comprehensive support for individuals with serious mental illness; service type: clubhouse-based psychosocial rehabilitation services; typical site of service: community clubhouse or day program setting, billed per diem for participation and access to clubhouse resources and activities.

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

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HCPCS H2031: Mental Health Clubhouse Services, Per Diem

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Get alerted when payer policies referencing H2031 are released or updated.

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Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with serious and persistent mental illness (for example, schizophrenia, schizoaffective disorder, bipolar disorder, or major depressive disorder with functional impairment) who attends a community-based mental health clubhouse for day-long psychosocial rehabilitation. The clubhouse model provides structured therapeutic activities, peer support, vocational training, and socialization. A member arrives in the morning, signs in, participates in a staff-led work-ordered day (skill-building, meal preparation, supported employment planning), receives case management check-ins, and obtains referrals or assistance with community resources. Staff document attendance, interventions provided, and any individualized service planning. Per-diem billing with H2031 is used to capture the clubhouse day of service regardless of the specific discrete tasks performed during that day; clinical documentation supports the diagnosis, functional goals, and time/date of service. Typical sites of service include nonprofit clubhouse facilities, community mental health centers, or certified behavioral health program locations. Common payer interactions include verification of member eligibility, prior authorization if required by Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, or Medicare, and submission of the per-diem claim with appropriate modifier(s) when applicable.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`90853`	Group psychotherapy (other than of a multiple-family group)	Group therapy sessions held within the clubhouse as part of the day; may be billed separately when payer policy allows separate payment in addition to per-diem.
`90832`	Psychotherapy, 30 minutes with patient	Individual psychotherapy that may occur before or after clubhouse attendance; billed separately when provided by a clinician and allowed by payer policy.
`90834`	Psychotherapy, 45 minutes with patient	Longer individual therapy sessions provided to members in coordination with clubhouse services; billed when separate from the per-diem.
`99401`	Preventive medicine counseling, 15 minutes	Brief health promotion or wellness counseling provided during the clubhouse day; billed separately if payer permits.
`96127`	Brief emotional/behavioral assessment (e.g., depression inventory)	Routine brief screening or outcome measures used to track member progress; billed adjunctively when separately reportable.

Related Modifiers

6 rows

Modifier	Description	When to Use
52	Modifier ‑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…
53	Modifier 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…
54	Modifier ‑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…
55	Modifier –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…
56	Modifier ‑56 indicates the reporting provider furnished only the preoperative management for a surgical procedure and did not perform the intraoperative or postoperative care. It is used in…	- Use Modifier -56 when a provider performs only the preoperative management in a split‑care situation (one physician manages preop care while a different physician performs the intraoperative…
62	Modifier 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 Code	Specialty	Notes
101Y00000X	Counselor	A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and …
103T00000X	Psychologist	A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, a…
106H00000X	Marriage & Family Therapist	A 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…
163W00000X	Registered Nurse	(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive…
363L00000X	Nurse Practitioner	(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
364SX0200X	Oncology Clinical Nurse Specialist	Physician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
2251E1200X	Ergonomics Physical Therapist	A licensed physical therapist who has demonstrated specialized knowledge and skills pertaining to the workplace, occupational demands, prevention of w…
207RB0002X	Obesity Medicine (Internal Medicine) Physician	A physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the ge…

Related Payer Policy Updates

Specialty: Home Health & Hospice1 / 3

10 rows

Policy	Payer	Effective Date
Home Health, Skilled, and Custodial Care Services (for Idaho Only)	UnitedHealthcare	2026-08-01
Private Duty Nursing Services (for Florida Only)	Colorado Rocky Mountain Health Plans	2026-08-01
Private Duty Nursing Services	Colorado Rocky Mountain Health Plans	2026-08-01
Private Duty Nursing Services (for New Jersey Only)	UnitedHealthcare	2026-08-01
Private Duty Nursing Services (for New Mexico Only)	UnitedHealthcare	2026-08-01
Private Duty Nursing Services (for Kentucky Only)	UnitedHealthcare	2026-08-01
Private Duty Nursing Services	Colorado Rocky Mountain Health Plans	2026-08-01
Private Duty Nursing Services (for Kansas Only)	UnitedHealthcare	2026-08-01
Home Health, Skilled, and Custodial Care Services (for Ohio Only)	UnitedHealthcare	2026-08-01
Home Health, Skilled, and Custodial Care Services	Colorado Rocky Mountain Health Plans	2026-07-01

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

Frequently Asked Questions

References

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.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.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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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`90853`	Group psychotherapy (other than of a multiple-family group)	Group therapy sessions held within the clubhouse as part of the day; may be billed separately when payer policy allows separate payment in addition to per-diem.
`90832`	Psychotherapy, 30 minutes with patient	Individual psychotherapy that may occur before or after clubhouse attendance; billed separately when provided by a clinician and allowed by payer policy.
`90834`	Psychotherapy, 45 minutes with patient	Longer individual therapy sessions provided to members in coordination with clubhouse services; billed when separate from the per-diem.
`99401`	Preventive medicine counseling, 15 minutes	Brief health promotion or wellness counseling provided during the clubhouse day; billed separately if payer permits.
`96127`	Brief emotional/behavioral assessment (e.g., depression inventory)	Routine brief screening or outcome measures used to track member progress; billed adjunctively when separately reportable.

Related Modifiers

6 rows

Modifier	Description	When to Use
52	Modifier ‑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…
53	Modifier 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…
54	Modifier ‑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…
55	Modifier –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…
56	Modifier ‑56 indicates the reporting provider furnished only the preoperative management for a surgical procedure and did not perform the intraoperative or postoperative care. It is used in…	- Use Modifier -56 when a provider performs only the preoperative management in a split‑care situation (one physician manages preop care while a different physician performs the intraoperative…
62	Modifier 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 Code	Specialty	Notes
101Y00000X	Counselor	A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and …
103T00000X	Psychologist	A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, a…
106H00000X	Marriage & Family Therapist	A 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…
163W00000X	Registered Nurse	(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive…
363L00000X	Nurse Practitioner	(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
364SX0200X	Oncology Clinical Nurse Specialist	Physician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
2251E1200X	Ergonomics Physical Therapist	A licensed physical therapist who has demonstrated specialized knowledge and skills pertaining to the workplace, occupational demands, prevention of w…
207RB0002X	Obesity Medicine (Internal Medicine) Physician	A physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the ge…

Related Payer Policy Updates

Specialty: Home Health & Hospice1 / 3

10 rows

Policy	Payer	Effective Date
Home Health, Skilled, and Custodial Care Services (for Idaho Only)	UnitedHealthcare	2026-08-01
Private Duty Nursing Services (for Florida Only)	Colorado Rocky Mountain Health Plans	2026-08-01
Private Duty Nursing Services	Colorado Rocky Mountain Health Plans	2026-08-01
Private Duty Nursing Services (for New Jersey Only)	UnitedHealthcare	2026-08-01
Private Duty Nursing Services (for New Mexico Only)	UnitedHealthcare	2026-08-01
Private Duty Nursing Services (for Kentucky Only)	UnitedHealthcare	2026-08-01
Private Duty Nursing Services	Colorado Rocky Mountain Health Plans	2026-08-01
Private Duty Nursing Services (for Kansas Only)	UnitedHealthcare	2026-08-01
Home Health, Skilled, and Custodial Care Services (for Ohio Only)	UnitedHealthcare	2026-08-01
Home Health, Skilled, and Custodial Care Services	Colorado Rocky Mountain Health Plans	2026-07-01

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

Frequently Asked Questions

References

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.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.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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HCPCS H2031: Mental Health Clubhouse Services, Per Diem

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HCPCS H2031: Mental Health Clubhouse Services, Per Diem

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

References

HCPCS H2031: Mental Health Clubhouse Services, Per Diem

Sign up for hcpcs H2031 policy alerts

HCPCS H2031: Mental Health Clubhouse Services, Per Diem

Sign up for hcpcs H2031 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What does HCPCS code H2031 represent?

How is H2031 billed and what documentation is needed?

Can other CPT codes be billed alongside H2031?

What diagnoses or clinical situations commonly justify H2031 services?

Where are clubhouse services provided and what payer interactions should be expected?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What does HCPCS code H2031 represent?

How is H2031 billed and what documentation is needed?

Can other CPT codes be billed alongside H2031?

What diagnoses or clinical situations commonly justify H2031 services?

Where are clubhouse services provided and what payer interactions should be expected?

References