MedicaidBilling CodesMedium impact
Attention LEA Providers: Behavioral Health Procedure Codes Added to the School-Based Medicaid Program
Louisiana Medicaid·LA · Psychiatry·Specialty Services
Effective date
Aug 29, 2025
We identified it
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.
Action Required
By August 29, 2025: LEA 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). Add these codes to encounter forms and verify billing software can process SBMP claims for these behavioral health services. Contact Gainwell Technologies at (800) 473-2783 for questions about implementation.