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Louisiana MedicaidMedicaid · Billing Codes · Specialty Services · LA · PsychiatryMedium impact

Attention LEA Providers: Behavioral Health Procedure Codes Added to the School-Based Medicaid Program

Act
by Aug 29, 2025
Effective date
Aug 29, 2025
Identified
Jun 18, 2026

Summary

Louisiana's School-Based Medicaid Program (SBMP) is adding two new behavioral health procedure codes effective August 29, 2025: H0004 for behavioral health counseling/therapy (per 15 minutes) at $10.00 and H0005 for alcohol/drug group counseling at $10.00. This expansion is part of SBMP's commitment to provide substance abuse coverage services to eligible students.

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What to do

by Aug 29, 2025 · 3 steps
01LEA providers must update billing systems to include new HCPCS codes H0004 ($10.00 rate for behavioral health counseling per 15 minutes) and H0005 ($10.00 rate for alcohol/drug group counseling).
02Add these codes to encounter forms and verify billing software can process SBMP claims for these behavioral health services.
03Contact Gainwell Technologies at (800) 473-2783 for questions about implementation.

Codes mentioned

H0004H0005

Original notice

Attention LEA Providers: Behavioral Health Procedure Codes Added to the School-Based Medicaid Program
lamedicaid.com · Always check the source before changing claims.
View original ↗

Related policy hubs

Louisiana Medicaid policiesLA policy changesPsychiatryCode H0004Code H0005

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