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    v1.0.28
    OpenPayerBilling CodesAlcohol and Drug Abuse TreatmentHCPCS hcpcs-h2038-skills-training-development-per-diem
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    HCPCS H2038: Skills Training and Development, Per Diem

    HCPCS Level II code H2038 represents per diem skills training and development services typically provided in community mental health or behavioral health program settings; this code covers daily rates for structured skills training activities aimed at improving daily living, social, and vocational skills and is billed for facility-based or community-based program days as a per-day service.

    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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    Table of contents

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    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
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    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
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    • Coverage CriteriaMedical necessity by payer
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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult with a serious and persistent mental illness (for example, schizophrenia, schizoaffective disorder, bipolar disorder, or severe major depressive disorder) who requires structured community-based psychosocial rehabilitation to improve daily living, social, and vocational skills. The service H2038 (Skills training and development, per diem) is delivered by a behavioral health rehabilitation program in an outpatient clinic, community mental health center, or residential treatment setting. A clinician (often an LMSW, LCSW, LPC, psychologist, or psychiatric rehabilitation specialist) provides goal-directed training in areas such as independent living, medication management, symptom recognition, social skills, money management, transportation use, and work-readiness.

    The clinical workflow begins with a comprehensive behavioral health assessment and individualized service plan identifying functional deficits and measurable skill-training goals. Skills training sessions are scheduled daily or several times weekly as indicated; billing uses a per diem unit (H2038) for a day of documented specialized training. Each billed day requires documentation of the specific skills taught, participant engagement, objective progress toward treatment goals, time spent in direct skill-training activities, and clinician qualifications. Coordination with the treating psychiatrist, primary care provider, family, and supported employment/education services occurs as needed. Periodic reassessments update the individualized plan and support medical necessity for continued per diem billing.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    96127Brief emotional/behavioral assessment (e.g., depression inventory, ADHD screening), with scoring and documentation, per standardized instrumentUsed to document baseline or interval symptom measurement supporting individualized goals for skills training and to track outcomes.
    90853Group psychotherapy (other than of a multiple-family group)Group-based skills training components (social skills, coping, role-play) often billed as group psychotherapy when clinical content meets payer criteria.
    90832Psychotherapy, 30 minutes with patientIndividual psychotherapy sessions that may occur alongside skills training to address underlying psychiatric symptoms interfering with skill acquisition.
    H2014Skills training and development, per 15 minutes (non-physician behavioral health rehabilitation)May be billed in some programs as an alternative to per diem H2038 when time-based 15-minute units are appropriate; relates to granular documentation of skill-building time.
    97535Self-care/home management training (e.g., ADLs, meal prep), direct one-on-one, each 15 minutesOccupational therapy or rehabilitation-type interventions for ADL/IADL training that complement service content.

    Related Modifiers

    8 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…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    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…
    56Modifier ‑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…
    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
    103T00000XPsychologistA psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, a…
    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…
    207RC0000XCardiovascular Disease PhysicianAn internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threaten…
    175F00000XNaturopathDiagnoses, treats, and cares for patients, using system of practice that bases treatment of physiological functions and abnormal conditions on natural…
    163WR0400XRehabilitation Registered NurseNursing Service Providers · Registered Nurse
    125K00000XAdvanced Practice Dental TherapistAn Advanced Practice Dental Therapist is:<br/>(1) A dental therapist who has completed additional training beyond basic dental therapy education and p…
    3336N0007XNuclear PharmacyA pharmacy dedicated to the compounding and dispensing of radioactive materials for use in nuclear imaging and nuclear medical procedures.

    Related ICD-10-CM Codes

    27 rows

    ICD-10-CM CodeDescription
    E66.9Obesity, unspecified
    F32.9Major depressive disorder, single episode, unspecified
    F33.1Major depressive disorder, recurrent, moderate
    F41.1Generalized anxiety disorder
    F41.9Anxiety disorder, unspecified
    F43.10Post-traumatic stress disorder, unspecified
    F43.21Adjustment disorder with depressed mood
    F60.3Borderline personality disorder
    F60.6Avoidant personality disorder
    F71Moderate intellectual disabilities

    Showing 1–10 of 27

    Related Payer Policy Updates

    Specialty: Home Health & Hospice1 / 3

    9 rows

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

    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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    H2038