2025 HCPCS code HX
Indicates that the provider receives funds from a county or local agency to provide therapy to a patient.
Medical necessity for the underlying behavioral health service must be established.The use of modifier HX signifies the funding source but does not independently establish medical necessity.
The provider is responsible for delivering the therapy and maintaining documentation that validates the funding source.
In simple words: This code is used when a local government agency helps pay for your mental health therapy.
This modifier is appended to a behavioral health service code to indicate that the provider receives funds from a county or local agency for the therapy provided to the patient. The medical documentation must confirm that the county or local agency is funding the treatment service. The agency arranges the financing for the therapy, and the provider uses these resources to offer mental and behavioral health care to the patient.
Example 1: A patient receives counseling services for depression, and the county mental health agency covers the cost of the sessions., A child receives play therapy for behavioral issues, with the local child welfare agency funding the treatment., An individual receives substance abuse counseling, and the cost is covered by a local agency dedicated to addiction services.
Documentation must clearly indicate that the therapy services are funded by the county or local agency, including the agency's name and any relevant authorization or referral information. The clinical record should also support the medical necessity of the therapy provided.
- Specialties:Behavioral health providers, therapists, counselors, psychiatrists, psychologists, social workers
- Place of Service:Applicable places of service will vary depending on the specific therapy being provided and the agency's policies.This could include outpatient facilities, community mental health centers, or even the patient's home.