Code
Unit Value
H0001
Per Service
H0002t
Per Service
H0004
Per 15 Minutes
H0005
Per Service
T1006
Per Service
H0006
Per 15 Minutes
For Outpatient Services provided as of March 1, 2014
Multco Amount
Description
One assessment equals one unit of service. Service frequency limitation is based upon medical appropriateness for
Alcohol and Drug
the individual. 1 unit per billing regardless of length of time or if it takes multiple sessions to complete the initial
Assessment
$
125.00 assessment for the individual.
Screening/Pre-enrollment
Individuals are screened for substance use disorders to ensure appropriate treatment is given. This service may be
service
$
35.00 delivered to individuals not currently enrolled in treatment. 1 unit per billing service.
Providing individual counseling for an individual in a private setting as identified in the assessment and listed in the
treatment plan. Service frequency limitation is based on medical appropriateness for the individual. 1 unit equals 15
Individual Counseling
$
16.00 minutes of individual counseling.
Length of group sessions are not specified or dictated by DCJ/DCHS. For Guidelines on recommended session length,
refer to SAMHSA'S TIP 41 or other Evidence Based Practice Guidelines. Depending upon group focus (i.e. psychoeducational, skills development, cognitive behavioral, relapse prevention, culturally specific etc.) length of group
session can vary 15-120 minutes. Service frequency limitation is based upon medical appropriateness and treatment
Group Counseling- up to
plans for the individual. Multiple group sessions are allowable within a day. 1 unit equals 1 group session regardless
2 hours
$
36.00 of length of session.
This code provides family or couple counseling in a private setting as identified by the assessment and listed in the
Family/couple counseling $
79.00 treatment plan.
Service frequency limitation is based upon medical appropriateness and treatment plans for the individual. Services
Case Management
$
17.46 must be delivered by a CADC.
HCPCS/CPT
Uninsured
Clients
Only
H0015
Per Service
Group Counseling- more
than 2 hours
$
This service is only reimbursed to treatment providers for individuals assessed at IOP and when the individuals have
received at least three hours of group therapy in a single day. Service frequency limitation is based upon medical
appropriateness and treatment plans for the individual. 1 unit of service equals 3 hours of total group therapy within
a single day, which could be multiple group sessions or a single session. Appropriate clinical documentation still
71.00 applies. This code is not billable on the same day as H0005.
$
(UAs) for alcohol/drug analysis. To ensure the integrity of the specimen a chain of custody from the point of
collection throughout the analysis process is necessary. Service frequency limitation is based upon medical
12.00 appropriateness and treatment plans for the individual. 1 unit equals one collection and handling.
Per Service
Alcohol and/or drug
testing
97810/97811/
97813/97814
Per Service
Acupuncture- 15 minutes
of personal one-on-one
contact
$
T1013
Per 15 Minutes
H0020
Per Service
H0048
Interpretation Services
Methadone
Administration and/or
services
$
$
Acupuncture therapy by inserting one or more fine needles into the individual as dictated by acupuncture meridians
for the treatment of substance abuse. Requires 15 minutes of personal one-on-one contact with the individual. This
10.00 code encompasses DMAP codes for initial and subsequent 15 minutes, with or without electrical stimulation.
7.50 This code is used for sign language or oral interpretation for services provided.
This code is used for methadone maintenance therapy medication administration. The patient is closely supervised
adhering to all federal regulations of methadone maintenance. Take home does must comply with OAR 415-0204.00 0053. Frequency limitations up to 30 doses per month.
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Code
Unit Value
H0016
Per Service
HCPCS/CPT
Medical/somatic
intervention in
ambulatory setting
Multco
Amount
Description
For
Outpatient
Services provided
as of March 1, 2014
This service includes the supervision of medication, physical examinations, or other medical needs required to
maintain the physical health of the patient receiving medical intervention treatment for alcohol and drug related
$
71.00 problems. 1 physical per 12 months
This code represents skills development, which can be work‐related, life skills, coping skills, or similar types of skills that are needed to successfully attain a goal in relation to alcohol and/or substance abuse
services.
T1012
Per Service
T1009
Per Hour
Skills Training and
Development- Group
Setting
Child Sitting Services for
children of individual
receiving a/d services
Per 15 Minutes
Telephonic/Internet
based Recovery Support
Insured OR
AD123
Uninsured
Clients
Uninsured
Clients
Only
H0038
Per 15 Minutes
Peer Recovery Support
Services
$
Examples: Educational services delivered by the provider to enhance recovery potential through the development of
employment readiness and job search skills; parenting skills; interpersonal relationship skills; and housing retention
36.00 and tenancy skills.
$
Onsite child sitting services delivered by the provider to the child(ren) of the individual client receiving A&D services
15.00 while that client is attending those services.
$
Recovery supports provided remotely through telecommunications technologies (telephone, texts, instant
16.00 messaging, video conference, Skype, remote training, confidential email, etc.).
$
Individual direct services provided by peers who are in substance abuse/addiction recovery, delivered either onsite or
in the community, to promote successful client service engagement and potential for a clean and sober life in
recovery. Services may include but are not limited to client outreach and engagement, support for or delivery of prosocial activities, client advocacy with allied social services, recovery coaching, client mentoring and assistance
navigating community-based recovery resources. Must be currently certified, or certified within six months, as a
16.00 Certified Recovery Mentor.
Housing assistance in the form of direct payment to vendor for a) move-in costs, deposits, and/or rent assistance for
clients acquiring or maintaining alcohol and drug free housing, as defined by Oregon Law ORS 90.243 (see
http://www.oregonlaws.org/ors/90.243); b) housing-related utilities costs. Clients must be enrolled in A&D
treatment and the housing must be within Multnomah County geographic boundaries.
AD456
Housing Assistance
Actual Cost
Reimbursement
*Note: Housing assistance shall not exceed 30% of the total value of the contract for outpatient services within the
current fiscal period. Any applicable receipts, invoices, or other records documenting housing-related expenses must
be retained and available for review audit purposes.
3/25/2014
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