HCPCS H2035: Alcohol and/or Other Drug Treatment Program, Per Hour
HCPCS Level II code H2035 denotes an hourly rate for alcohol and/or other drug treatment program services, capturing time-based counseling and structured program activities used in substance use disorder care. This code is nationally relevant as insurers increasingly track and reimburse program-based behavioral health services separately from per-diem or bundled placements. Payers commonly addressing H2035 in coverage and claims include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of what H2035 represents, how it fits alongside related service codes (per-diem variants and other outpatient substance use disorder services), and clinical context for use in programmatic, outpatient behavioral health settings. The publication summarizes typical billing scenarios, payer coverage scope, and common policy considerations that affect claims for hourly treatment programs. It also highlights associated clinical diagnoses commonly coded with these services and professional taxonomies that typically deliver them. Data not available in the input is noted where applicable.
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Billing Code Overview
HCPCS Level II code H2035 represents an alcohol and/or other drug treatment program billed per hour. The service covers time-based treatment activities provided as part of a structured substance use disorder treatment program. Typical service type is hourly substance use disorder treatment services, and the typical site of service is outpatient or program-based behavioral health settings where time-based counseling, therapy, or program interventions are delivered.
National Reimbursement Benchmarks
Across national commercial payers BUCA (average commercial) sits near the mid-market with an average rate of $48.10, providing a useful anchor against more variable carrier outcomes. Blue Cross Blue Shield exhibits the widest interquartile dispersion with P75−P25 = $37.70 ($59.60 − $22.90), indicating substantial variability among contracted rates, while Aetna shows one of the tightest IQRs at $7.00 ($63.00 − $56.00), reflecting relatively clustered reimbursement levels.
UnitedHealth Group and Cigna fall between those extremes: UnitedHealth Group’s IQR is $33.20 ($61.70 − $32.50) and Cigna’s IQR is $21.90 ($54.40 − $31.50). BUCA’s IQR is $25.90 ($59.70 − $33.80). These comparisons highlight where commercial rate dispersion concentrates across payers without implying policy or billing actions.