CPT CODE S5140, T1019, S5100, H2011 with covered DX

Certified Family Home (CFH) 

HCPCS Description Place of Service

S5140  Certified Family Home – Daily One to two participants Foster Care – Adult; per diem 1 unit = 1 day
T1019 Personal Care Service per 15 minutes
S5100 Adult Foster Care
H2011 Crisis intervention per 15 minutes

12 Home
33 Custodial Care Facility
99 Other

HCPCS Modifier Description Diagnosis Place of Service

H2019 Therapeutic Behavioral Services 1 Unit = 15 minutes
H2019 HM Therapeutic Behavioral Services Limited to 96 units per calendar month. 1 Unit = 15 minutes
H2011 Community Crisis supports (1 unit = 15 minutes)

Based on dates of service, enter the ICD-9-CM code V60.4 or the ICD-10-CM code Z74.2 for the primary diagnosis.
For more information on which ICD version to use, refer to ICD-9 and ICD-10 Diagnosis Billing Requirements.

11 Office
12 Home
99 Other (Community)

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