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