Outpatient Prospective Payment System (hospital outpatient)
C7902 — Service for diagnosis, evaluation, or treatment of a mental health or substance use disorder, each additional 15 minutes, provided remotely by hospital staff who are licensed to provide mental health services under applicable state law(s), when the patient is in their home, and there is no associated professional service (list separately in addition to code for primary service)
HCPCS code C7902 is used on U.S. medical bills for outpatient prospective payment system (hospital outpatient): Service for diagnosis, evaluation, or treatment of a mental health or substance use disorder, each additional 15 minutes, provided remotely by hospital staff who are licensed to provide mental health services under applicable state law(s), when the patient is in their home, and there is no associated professional service (list separately in addition to code for primary service).
- Typical setting: Hospital outpatient
- National avg charge (illustrative): OPPS payments — review the Medicare APC weight if you are on Medicare.
- Most-disputed reason: Unbundling
What it means
What C7902 actually means
Service for diagnosis, evaluation, or treatment of a mental health or substance use disorder, each additional 15 minutes, provided remotely by hospital staff who are licensed to provide mental health services under applicable state law(s), when the patient is in their home, and there is no associated professional service (list separately in addition to code for primary service).
The official CMS HCPCS Level II descriptor for this code is shown above. If the description on your bill does not match the service you actually received, that is a reason to ask for the itemized bill and dispute the line.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Quantity or units of service that exceed what the medical record supports.
- Duplicate billing on the same date of service.
- Missing or incorrect modifier (e.g., JW for drug waste, RT/LT for sides).
- Unbundling without supporting documentation.
If you see C7902 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on C7902 often also see these adjacent codes on the same bill.
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C1601 — Endoscope, single-use (i.e. disposable), pulmonary, imaging/illumination device (insertable)
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HCPCS
C1602 — Orthopedic/device/drug matrix/absorbable bone void filler, antimicrobial-eluting (implantable)
Orth/matrx/bn fill drug-elut
Related BillBusted guides
Plain-English reads if you see C7902 on a bill.
C7902 FAQ
Plain-English answers.
What is C7902 used for on a medical bill?
HCPCS code C7902 is used on medical bills for outpatient prospective payment system (hospital outpatient): Service for diagnosis, evaluation, or treatment of a mental health or substance use disorder, each additional 15 minutes, provided remotely by hospital staff who are licensed to provide mental health services under applicable state law(s), when the patient is in their home, and there is no associated professional service (list separately in addition to code for primary service). Up to 49% of medical bills contain at least one error (CFPB, 2023), and codes in this category most often get flagged for unbundling. If you see C7902 on your bill, request the itemized statement and compare the units, date of service, and description to your Explanation of Benefits before paying.
How much should C7902 cost?
How much C7902 should cost depends on your payer and region. Up to 49% of medical bills contain at least one error (CFPB, 2023), and pricing for this HCPCS code is set by Medicare fee schedules for Medicare claims and by negotiated allowed amounts for commercial plans. Check the Medicare fee-schedule lookup tool, your insurer's member portal, or run a free BillBusted scan to compare your charge against typical allowed amounts.
Can I dispute a C7902 charge on my medical bill?
Yes, you can dispute a C7902 charge on your medical bill if the units, modifier, date of service, or coverage doesn't match the medical record or your insurance benefits. About 73.7% of patients who actually dispute a medical bill receive a correction (JAMA Health Forum, 2024). Request the itemized bill, compare to your EOB, and use BillBusted's Resolution Pack to draft the dispute letter if needed.
Don't pay C7902 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.