MedicaidBilling CodesMedium impact
Behavioral Health Code Addition
Kentucky Medicaid·KY · Psychiatry·Coding
Effective date
Apr 1, 2023
We identified it
Jun 20, 2026
Summary
Kentucky Medicaid has added a new billing code H0004 for prolonged behavioral health services, effective April 1, 2023. This code must be billed with CPT 90837 and is limited to 8 units per date of service for 15-minute increments of prolonged counseling and therapy.
Action Required
By April 1, 2023: Billing team must update billing system to include new HCPCS code H0004 for behavioral health prolonged services. Configure system to require H0004 be billed only with CPT 90837 and enforce maximum limit of 8 units per date of service. Update encounter forms for behavioral health providers to include H0004 option.