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December 2016 Texas Medicaid Provider Procedures Manual

Behavioral Health, Rehabilitation, and Case Management Services Handbook : 8 Substance Use Disorder (SUD) Services (Abuse and Dependence) : 8.6 Treatment Services : 8.6.2 Ambulatory (Outpatient) Treatment Services

8.6.2
Ambulatory (outpatient) treatment services must be billed with procedure codes H0004 or H0005 and modifier HF.
Procedure codes H0004 and H0005 are limited to the following diagnosis codes:
 

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