2025 HCPCS code H0046
(Active) Effective Date: N/A Revision Date: N/A Behavioral Health - Mental Health Services Miscellaneous Drug and Alcohol Services Feed
Mental health services not specified elsewhere.
Modifiers may be applicable depending on the circumstances of service.Consult modifier guidelines for specific scenarios.
Medical necessity for H0046 would be established by a documented diagnosis of a mental health condition, and the need for services must be clinically justified based on the patient's presentation, assessment findings, and treatment goals.The services must be reasonable and necessary for the treatment of the patient's condition.
Licensed mental health professionals (e.g., psychiatrists, psychologists, licensed clinical social workers, etc.) are responsible for providing and documenting these services.Clinical responsibility includes conducting thorough assessments, developing individualized treatment plans, delivering interventions, and monitoring patient progress.
In simple words: This code is used for mental health services that aren't described by other, more specific codes. It covers many different types of therapy and counseling to help people with mental health issues.
HCPCS code H0046, "Mental health services, not otherwise specified," encompasses a wide range of therapeutic, diagnostic, and counseling services provided to individuals experiencing diverse mental health challenges.These services are not otherwise specified by a more specific HCPCS code. The services provided may vary greatly depending on patient needs and the provider's approach, and can include individual or group therapy, medication management, and other interventions.
Example 1: A patient presents with generalized anxiety disorder and receives six sessions of individual therapy over a period of three months. H0046 would be used to bill for these sessions as the specific type of therapy is not specified by another HCPCS code., A patient diagnosed with major depressive disorder undergoes a combination of medication management and brief weekly therapy sessions.H0046 can be used if no more specific code is applicable., A patient is seen for a single session of crisis intervention following a traumatic event.If the crisis intervention does not fall under a different HCPCS code, H0046 may be utilized.
Comprehensive documentation is crucial and should include:patient's diagnosis, treatment goals, detailed notes of each session,assessment results, progress notes, and any relevant clinical measures (e.g., PHQ-9, GAD-7).
** H0046 is a catch-all code; use it only when no other more specific code applies.State Medicaid agencies may have additional rules for using this code.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier is not typically applicable to H0046, as it represents a professional service.
- Fee Schedule : Fee schedules vary by payer and location. Consult the relevant fee schedule for your area and payer.
- Specialties:Psychiatry, Psychology, Clinical Social Work, Counseling, Behavioral Health
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital, Telehealth, Other Place of Service (as appropriate)