H2016 Complicated comm supp service, per diem
Also known as: community support services, support services, day support
Comprehensive community support services on a per diem basis including care coordination and assistance.
In Plain Language
daily community support; behavioral health assistance
Clinical Context
Used for comprehensive daily community-based support services including assistance with daily living, community integration, and resource access.
RVU Information
CPT H2016 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 H2016?
CPT H2016 (Complicated comm supp service, per diem) is a Other HCPCS code. Comprehensive community support services on a per diem basis including care coordination and assistance.
Does Medicare cover H2016?
Medicare coverage for H2016 depends on medical necessity and applicable Local Coverage Determinations (LCDs). Used for comprehensive daily community-based support services including assistance with daily living, community integration, and resource access. A physician order is typically required.
When is CPT H2016 used?
Used for comprehensive daily community-based support services including assistance with daily living, community integration, and resource access.
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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.