H0038 Self-help/peer service per 15min
Also known as: peer support, self-help group, support group
Self-help and peer support services for individuals with behavioral health conditions per 15-minute increment.
In Plain Language
support group; peer counseling
Clinical Context
Used for peer-led and self-help support programs including group meetings, peer counseling, and mutual aid activities for individuals with mental health or substance abuse issues.
RVU Information
CPT H0038 does not have a physician work RVU assigned by CMS. Reimbursement for this code is determined by payer-specific fee schedules.
Billing & Documentation
This HCPCS code requires documentation of medical necessity and a valid physician order. Coverage and reimbursement policies vary by payer. Check with the specific insurer for prior authorization requirements.
Specialties
Frequently Asked Questions
What is CPT code H0038?
CPT H0038 (Self-help/peer service per 15min) is a Other HCPCS code. Self-help and peer support services for individuals with behavioral health conditions per 15-minute increment.
Does Medicare cover H0038?
Medicare coverage for H0038 depends on medical necessity and applicable Local Coverage Determinations (LCDs). Used for peer-led and self-help support programs including group meetings, peer counseling, and mutual aid activities for individuals with mental health or substance abuse issues. A physician order is typically required.
When is CPT H0038 used?
Used for peer-led and self-help support programs including group meetings, peer counseling, and mutual aid activities for individuals with mental health or substance abuse issues.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.