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Tornados in Kentucky – Relief Response. Learn More.

H2027 and H0038 Limits Policy

Please note that WellCare of Kentucky is continuing the program limits (listed below) previously established by the Department for Medicaid Services on January 1, 2025, for peer support and psychoeducationservices.

H2027 (Psychoeducation Limits)

  • 8 units (2 hours) per day
  • 500 units (125 hours) per calendar year

H0038 (Peer Support Limits)

  • 8 units (2 hours) per day
  • 800 units (200 hours) per calendar year

As a reminder, WellCare of Kentucky providers who receive claim denials above the stated limits will need to appeal to demonstrate medical necessity. Instructions for appeals can be found within the WellCare Quick Reference Guide or within the Explanation of Payment (EOP). If you have any questions regarding this notice, please contact your assigned Provider Engagement Account Manager.