HCPCS H0022 is officially defined as "Alcohol and/or drug intervention service (planned facilitation)." HCPCS H0022 is referenced in 4 tracked payer policy changes from Sentara Health Plans, Wisconsin Medicaid (ForwardHealth), and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS H0022 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
Starting January 1, 2027, Sentara Health Plans will require prior authorization for a long list of codes on Virginia commercial plans, including self-funded (ASO) plans, and for code 88380 on commercial, Medicaid and Medicare products, plus code 22860 on Medicare products. Sentara will also stop covering a separate list of codes on Virginia commercial and self-funded plans.
Effective August 17, 2026, Narcotic Treatment Services (NTS) providers in Wisconsin must use Place of Service (POS) code 15 (Mobile Unit) when billing for services delivered via mobile treatment vehicles. This is a new coding requirement for mobile opioid treatment programs that extend brick-and-mortar sites. All existing coverage policy requirements (regulatory, documentation, staffing, confidentiality) apply to mobile unit services.
Effective December 1, 2025, ForwardHealth adds continuing care coverage for members discharged from DHS 75-certified outpatient substance use disorder treatment programs and requires the new U2 modifier on continuing care claims. It also reimburses outpatient mental health services as a concurrent service with residential SUD treatment, allows medication management through Comprehensive Community Services during residential SUD treatment, and covers point-of-care drug testing within the Intensive Outpatient Program, which must be billed with HCPCS code 80305.
ForwardHealth (Wisconsin Medicaid) expands behavioral health treatment options effective December 1, 2025, adding continuing care coverage for discharged SUD patients and allowing concurrent outpatient mental health services with residential SUD treatment. A new U2 modifier is required for billing continuing care services.
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