HCPCS S0201: Partial Hospitalization Services, Per Diem
Commercial payers pay $213 on average nationally for this procedure.
HCPCS Level II code S0201 describes partial hospitalization services, less than 24 hours, billed per diem, representing structured intensive outpatient psychiatric or behavioral health programming provided during the day rather than inpatient admission; service type is partial hospitalization (day program) and the typical site of service is a hospital-based or freestanding behavioral health partial hospitalization program (day treatment center).
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National Reimbursement Benchmarks
National commercial reimbursement for HCPCS S0201 centers on a BUCA average commercial rate of $212.70, with notable variation across major payers. Cigna shows the highest central tendency at a $718.80 median and mean, while Blue Cross Blue Shield sits near the lower-middle with a $128.50 median and $139.50 mean. Aetna’s mean of $274.30 and UnitedHealth Group’s mean of $54.60 further illustrate a skewed landscape where a few payers pay substantially more than others.
Examining dispersion (P75 minus P25) highlights where rates are tight or wide: Blue Cross Blue Shield’s dispersion is $13.40 ($134.50–$120.10), the tightest among listed payers, while UnitedHealth Group’s dispersion is $32.50 ($65.00–$32.50). Cigna and BUCA both show large spreads: Cigna’s is $606.50 ($718.80–$126.30) and BUCA’s is $129.70 ($256.10–$126.40). Aetna’s P75–P25 spread is $109.00 ($349.00–$240.00), indicating moderate variability.