Colorado BHA FHIR Implementation Guide
0.3.0-current - ci-build USA

Colorado BHA FHIR Implementation Guide, published by Colorado Behavioral Health Administration. This guide is not an authorized publication; it is the continuous build for version 0.3.0-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/CoBHA/CoBHRM-FHIR-IG/ and changes regularly. See the Directory of published versions

: CO BHA Service Identifier to CPT/HCPCS ConceptMap

Page standards status: Trial-use Maturity Level: 1

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{
  "resourceType" : "ConceptMap",
  "id" : "BHAServiceIdentifierProcedureCM",
  "language" : "en",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ConceptMap BHAServiceIdentifierProcedureCM</b></p><a name=\"BHAServiceIdentifierProcedureCM\"> </a><a name=\"hcBHAServiceIdentifierProcedureCM\"> </a><p>Mapping from <a href=\"ValueSet-bha-service-identifier-vs.html\">ValueSet for BHA Service Identifier Codes</a> to (not specified)</p><br/><p><b>Group 1 </b>Mapping from <a href=\"CodeSystem-bha-service-identifier-cs.html\">BHA Service Identifier Codes</a> to <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-CPT.html\">Current Procedural Terminology (CPT®)</a></p><table class=\"grid\"><tr><td><b>Source Code</b></td><td><b>Relationship</b></td><td><b>Target Code</b></td></tr><tr><td>00 (Differential Assessment (SUD) / Evaluation Only (MH))</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>90791 (Psychiatric diagnostic evaluation)</td></tr><tr><td>17 (Mental Health Outpatient)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>90837 (Psychotherapy, 60 minutes with patient)</td></tr><tr><td>19 (Mental Health Inpatient)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>99223 (Initial hospital inpatient care, high complexity)</td></tr><tr><td>22 (Psychiatric Hospitalization)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>99223 (Initial hospital inpatient care, high complexity)</td></tr></table><hr/><p><b>Group 2 </b>Mapping from <a href=\"CodeSystem-bha-service-identifier-cs.html\">BHA Service Identifier Codes</a> to <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-hcpcs-Level-II.html\">Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes</a></p><table class=\"grid\"><tr><td><b>Source Code</b></td><td><b>Relationship</b></td><td><b>Target Code</b></td></tr><tr><td>01 (Ambulatory Medical Withdrawal Management)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>H0014 (Alcohol and/or drug services; ambulatory detoxification)</td></tr><tr><td>02 (Residential (non-hospital) Withdrawal Management (RDX))</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>H0012 (Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient))</td></tr><tr><td>03 (Therapeutic Community (TC))</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>H2036 (Alcohol and/or other drug treatment program, per diem)</td></tr><tr><td>04 (Intensive Residential (IRT))</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>H0019 (Behavioral health; long-term residential)</td></tr><tr><td>05 (Transitional Residential (TRT)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>H2034 (Alcohol and/or drug halfway house services, per diem)</td></tr><tr><td>06 (Opioid Treatment Program (ORT/OTP))</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>H0020 (Alcohol and/or drug services; methadone administration and/or service)</td></tr><tr><td>07 (SUD Traditional Outpatient (OP and EOP)))</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>H0004 (Behavioral health counseling and therapy, per 15 minutes)</td></tr><tr><td>08 (STIRT)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>H0049 (Alcohol and/or drug screening)</td></tr><tr><td>09 (SUD Intensive Outpatient (IOP))</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>H0015 (Alcohol and/or drug services; intensive outpatient treatment)</td></tr><tr><td>10 (Day Treatment (DAY))</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>H2012 (Behavioral health day treatment, per hour)</td></tr><tr><td>11 (Medically Managed Inpatient Other Than WM)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>H0011 (Alcohol and/or drug services; acute detoxification (hospital inpatient))</td></tr><tr><td>12 (Medically Managed Inpatient Withdrawal Management)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>H0011 (Alcohol and/or drug services; acute detoxification (hospital inpatient))</td></tr><tr><td>13 (DUI Level I Education)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>H0025 (Behavioral health prevention education service)</td></tr><tr><td>14 (DUI Level II Education Only)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>H0025 (Behavioral health prevention education service)</td></tr><tr><td>15 (DUI Level II Therapy and Education)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>H0005 (Alcohol and/or drug services; group counseling by a clinician)</td></tr><tr><td>16 (Minors in Possession Treatment (MIP))</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>H0004 (Behavioral health counseling and therapy, per 15 minutes)</td></tr><tr><td>18 (Mental Health Residential)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>H2013 (Psychiatric health facility service, per diem)</td></tr><tr><td>20 (Crisis Stabilization)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>H2011 (Crisis intervention service, per 15 minutes)</td></tr><tr><td>21 (Crisis Respite)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>S9484 (Crisis intervention mental health services, per diem)</td></tr><tr><td>23 (Co-Occurring (CIRCLE))</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto\" title=\"relatedto\">is related to</a></td><td>H0004 (Behavioral health counseling and therapy, per 15 minutes)</td></tr></table></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger" : 1,
      "_valueInteger" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical" : "http://bha.colorado.gov/fhir/bha-ig/ImplementationGuide/bha-ig"
          }
        ]
      }
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode" : "trial-use",
      "_valueCode" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical" : "http://bha.colorado.gov/fhir/bha-ig/ImplementationGuide/bha-ig"
          }
        ]
      }
    }
  ],
  "url" : "http://bha.colorado.gov/fhir/bha-ig/ConceptMap/BHAServiceIdentifierProcedureCM",
  "version" : "0.3.0-current",
  "name" : "BHAServiceIdentifierProcedureCM",
  "title" : "CO BHA Service Identifier to CPT/HCPCS ConceptMap",
  "status" : "active",
  "experimental" : false,
  "date" : "2026-05-28T21:04:48+00:00",
  "publisher" : "Colorado Behavioral Health Administration",
  "contact" : [
    {
      "name" : "Colorado Behavioral Health Administration",
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://bha.colorado.gov"
        },
        {
          "system" : "email",
          "value" : "FHIRFeedback@state.co.us"
        }
      ]
    }
  ],
  "description" : "Informative (Colorado): Maps CO BHA service identifier codes to related CPT and HCPCS procedure/service concepts used in Colorado implementation workflows.",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "USA"
        }
      ]
    }
  ],
  "sourceUri" : "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-service-identifier-vs",
  "group" : [
    {
      "source" : "http://bha.colorado.gov/fhir/bha-ig/CodeSystem/bha-service-identifier-cs",
      "target" : "http://www.ama-assn.org/go/cpt",
      "element" : [
        {
          "code" : "00",
          "display" : "Differential Assessment (SUD) / Evaluation Only (MH)",
          "target" : [
            {
              "code" : "90791",
              "display" : "Psychiatric diagnostic evaluation",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "17",
          "display" : "Mental Health Outpatient",
          "target" : [
            {
              "code" : "90837",
              "display" : "Psychotherapy, 60 minutes with patient",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "19",
          "display" : "Mental Health Inpatient",
          "target" : [
            {
              "code" : "99223",
              "display" : "Initial hospital inpatient care, high complexity",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "22",
          "display" : "Psychiatric Hospitalization",
          "target" : [
            {
              "code" : "99223",
              "display" : "Initial hospital inpatient care, high complexity",
              "equivalence" : "relatedto"
            }
          ]
        }
      ]
    },
    {
      "source" : "http://bha.colorado.gov/fhir/bha-ig/CodeSystem/bha-service-identifier-cs",
      "target" : "http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets",
      "element" : [
        {
          "code" : "01",
          "display" : "Ambulatory Medical Withdrawal Management",
          "target" : [
            {
              "code" : "H0014",
              "display" : "Alcohol and/or drug services; ambulatory detoxification",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "02",
          "display" : "Residential (non-hospital) Withdrawal Management (RDX)",
          "target" : [
            {
              "code" : "H0012",
              "display" : "Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient)",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "03",
          "display" : "Therapeutic Community (TC)",
          "target" : [
            {
              "code" : "H2036",
              "display" : "Alcohol and/or other drug treatment program, per diem",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "04",
          "display" : "Intensive Residential (IRT)",
          "target" : [
            {
              "code" : "H0019",
              "display" : "Behavioral health; long-term residential",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "05",
          "display" : "Transitional Residential (TRT",
          "target" : [
            {
              "code" : "H2034",
              "display" : "Alcohol and/or drug halfway house services, per diem",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "06",
          "display" : "Opioid Treatment Program (ORT/OTP)",
          "target" : [
            {
              "code" : "H0020",
              "display" : "Alcohol and/or drug services; methadone administration and/or service",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "07",
          "display" : "SUD Traditional Outpatient (OP and EOP))",
          "target" : [
            {
              "code" : "H0004",
              "display" : "Behavioral health counseling and therapy, per 15 minutes",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "08",
          "display" : "STIRT",
          "target" : [
            {
              "code" : "H0049",
              "display" : "Alcohol and/or drug screening",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "09",
          "display" : "SUD Intensive Outpatient (IOP)",
          "target" : [
            {
              "code" : "H0015",
              "display" : "Alcohol and/or drug services; intensive outpatient treatment",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "10",
          "display" : "Day Treatment (DAY)",
          "target" : [
            {
              "code" : "H2012",
              "display" : "Behavioral health day treatment, per hour",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "11",
          "display" : "Medically Managed Inpatient Other Than WM",
          "target" : [
            {
              "code" : "H0011",
              "display" : "Alcohol and/or drug services; acute detoxification (hospital inpatient)",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "12",
          "display" : "Medically Managed Inpatient Withdrawal Management",
          "target" : [
            {
              "code" : "H0011",
              "display" : "Alcohol and/or drug services; acute detoxification (hospital inpatient)",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "13",
          "display" : "DUI Level I Education",
          "target" : [
            {
              "code" : "H0025",
              "display" : "Behavioral health prevention education service",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "14",
          "display" : "DUI Level II Education Only",
          "target" : [
            {
              "code" : "H0025",
              "display" : "Behavioral health prevention education service",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "15",
          "display" : "DUI Level II Therapy and Education",
          "target" : [
            {
              "code" : "H0005",
              "display" : "Alcohol and/or drug services; group counseling by a clinician",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "16",
          "display" : "Minors in Possession Treatment (MIP)",
          "target" : [
            {
              "code" : "H0004",
              "display" : "Behavioral health counseling and therapy, per 15 minutes",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "18",
          "display" : "Mental Health Residential",
          "target" : [
            {
              "code" : "H2013",
              "display" : "Psychiatric health facility service, per diem",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "20",
          "display" : "Crisis Stabilization",
          "target" : [
            {
              "code" : "H2011",
              "display" : "Crisis intervention service, per 15 minutes",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "21",
          "display" : "Crisis Respite",
          "target" : [
            {
              "code" : "S9484",
              "display" : "Crisis intervention mental health services, per diem",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "23",
          "display" : "Co-Occurring (CIRCLE)",
          "target" : [
            {
              "code" : "H0004",
              "display" : "Behavioral health counseling and therapy, per 15 minutes",
              "equivalence" : "relatedto"
            }
          ]
        }
      ]
    }
  ]
}