--- title: How to add your own billing codes, such as Medicaid local codes description: Add payer-specific billing codes that the national CPT/HCPCS set does not include, such as Medicaid local codes, and use them on services and claims. --- [Skip to content](https://support.pabau.com/en/pabau2/how-to-add-your-own-billing-codes-such-as-medicaid-local-codes#main-content) [![pabau logo white](https://support.pabau.com/hubfs/pabau%20logo%20white.svg)](https://support.pabau.com/en/pabau2?hsLang=en) Open main navigation Close main navigation - [Get Support](https://pabau.com/support-center/) [Get Support](https://pabau.com/support-center/) Pabau Knowledge Base - There are no suggestions because the search field is empty. 1. [Pabau Knowledge Base](https://support.pabau.com/en/pabau2?hsLang=en) 2. [Insurance Billing](https://support.pabau.com/en/pabau2/insurance-billing?hsLang=en) 3. [Insurance Billing (US)](https://support.pabau.com/en/pabau2/insurance-billing?hsLang=en#insurance-billing-us) # How to add your own billing codes, such as Medicaid local codes Pabau includes the full national CPT / HCPCS code set. Some payers, especially state Medicaid programs, also use their own local codes that the national sets leave out, for example Medi-Cal’s Z codes. In this article, you will learn how to add these as custom codes, set their default modifiers, and use them on your services and claims. **NOTE:** Only administrators can manage custom codes. If a code is already in the national CPT / HCPCS set, use that one instead. Pabau stops you adding it twice. **Step 1: Open Custom Codes** Go to **Setup → Diagnostic & Billing Codes**. Then: 1. Click the **Custom codes** tile. ![The Custom codes tile in Diagnostic and Billing Codes](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/kb/obc-2026/489460809940-01-tile.png) *The Custom codes tile in Diagnostic and Billing Codes* **Step 2: Add the Code** Click **Add custom code**. Then: 1. Enter the **Code** exactly as your payer publishes it. 2. Enter a **Label** your team will recognize, such as the payer’s description. 3. Click **Save**. ![Add a custom code with its label](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/kb/obc-2026/489460809940-02-add.png) *Add a custom code with its label* To change a code later, click **Edit** on its row. If you delete a code, claims and services that already use it keep it. **Step 3: Set Default Modifiers and Allowed Amounts (Optional)** Click **Defaults** on the code’s row. The **Default** row applies to every insurer, and an insurer’s own row overrides it for that insurer. 1. In **Modifiers**, enter any modifiers the payer requires with this code, two characters each, separated by a space (up to four). 2. In **Allowed amount**, enter the rate the payer has agreed to pay, if you know it. It is not sent to the payer. Pabau uses it for coinsurance figures and to make your accounts receivable realistic. 3. Use an insurer’s own row when that payer needs something different. ![Default modifiers and allowed amounts for a custom code](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/kb/obc-2026/489460809940-03-defaults.png) *Default modifiers and allowed amounts for a custom code* **Billed amount** comes from the price of the service linked to the code, so it follows your price lists. Click **Save** when you are done. **Step 4: Use the Code on a Service** Go to **Setup → Services**, open the service and select the **Pricing** tab. Then: 1. Click **Add A Billing Code**. 2. Choose **Custom code**, then pick your code. ![Choose Custom code to attach a custom code to a service](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/kb/obc-2026/489460809940-04-service-picker.png) *Choose Custom code to attach a custom code to a service* Once the code is on the service, set its **Default units** and **Place of service** in the same way as a CPT code. See [How to bill timed codes in units](https://support.pabau.com/en/pabau2/how-to-bill-timed-codes-in-units?hsLang=en). **IMPORTANT:** A service carries one billing code. Choosing a custom code replaces the service’s CPT / HCPCS code. If you bill the same treatment with a local code to one payer and a CPT code to others, create a separate service for each, or add the code to the client’s policy instead (see [How to add default billing codes to a client’s insurance policy](https://support.pabau.com/en/pabau2/how-to-add-default-billing-codes-to-a-clients-insurance-policy?hsLang=en)). **On Claims and Invoices** Custom codes appear in the code search on invoices and claim lines, marked **Custom**, so you can pick them like any other code. They travel to the payer in box 24D just like CPT codes. **What's next?** - [How to bill timed codes in units (such as 15-minute massage codes)](https://support.pabau.com/en/pabau2/how-to-bill-timed-codes-in-units?hsLang=en) - [How to set the place of service for home visits, mobile and telehealth claims](https://support.pabau.com/en/pabau2/how-to-set-the-place-of-service-for-home-visits-mobile-and-telehealth?hsLang=en) - [Box 24 – Service Lines](https://support.pabau.com/en/pabau2/box-24-service-lines?hsLang=en) - [Insurance Guide Part 1: Set up the insurance essentials in Pabau](https://support.pabau.com/en/pabau2/insurance-guide-part-1-set-up-the-insurance-essentials-in-pabau?hsLang=en) --- Was this guide helpful? Let us know by voting below - your feedback helps us write clearer articles. For **[more guides](https://support.pabau.com/en/pabau2?hsLang=en)**, browse the related articles below or use the search bar at the top of the page. 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