- Home
- Specialties
- Substance Use Treatment
Billing for substance use and addiction treatment programs
Billing for outpatient, intensive outpatient, partial hospitalization, detox and opioid treatment programs.
How substance use treatment billing works
Addiction treatment billing depends on the level of care. Professional services use CPT and HCPCS codes, while programs such as IOP and PHP are often billed on a facility claim with revenue codes, or with per diem HCPCS codes required by Medicaid and commercial plans.
Medicare pays opioid treatment programs with weekly bundled codes G2067–G2080.
Codes we bill every day
| Code | What it covers |
|---|---|
| H0001 | Alcohol and drug assessment |
| H0004 / H0005 | Individual and group substance use counseling |
| H0015 | Intensive outpatient program (Medicaid) |
| S9480 | Intensive outpatient psychiatric services, per diem (commercial) |
| H0020 | Methadone administration service |
| G2067–G2080 | Medicare opioid treatment program bundles |
| 99408 / 99409 | Screening and brief intervention (SBIRT) |
Code descriptions are summarized. Payer coverage and documentation rules vary by plan and state.
Denials we prevent
- Level of care not authorized or authorization lapsed
- Medical necessity criteria not documented
- Wrong claim type for the program level
- Daily services billed beyond authorized days
- Federal confidentiality rules (42 CFR Part 2) not followed when sharing records
Payer rules to watch
Payers usually authorize addiction treatment for a set number of days and review medical necessity often. We track concurrent reviews and authorization end dates, and protect patient records under 42 CFR Part 2 confidentiality rules.
Questions about substance use treatment billing
Do you bill IOP and PHP programs?
Yes, on the claim type and codes each payer requires, including revenue codes and per diem HCPCS codes.
Get a free substance use treatment billing audit
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.