Alcohol and/or other drug abuse services, not otherwise specified
Medicare coverage: Not payable by Medicare
Status: active (October 2026 file)
Medicare pricing for H0047
Physician Fee Schedule (CY 2026, RVU26D)
Status I: not valid for Medicare (Medicare uses another code).
Payer policies and prior authorization for H0047
12 of 12 payer prior-auth lists that name H0047 require prior authorization or set conditions: Blue Cross and Blue Shield of Illinois, Humana, Molina Healthcare of Illinois, Molina Healthcare of Iowa, Molina Healthcare of Texas, UnitedHealthcare Community Plan.
Payer
Plan
State
Prior auth
Conditions
Since
Source
Blue Cross and Blue Shield of Illinois
Blue Cross Community Health Plans (BCCHP), Illinois Medicaid
TX: $25.39 (outpatient_behavioral_health_chemical_dependencytreatment_fa, Outpatient Behavioral Health - Chemical Dependencytreatment Facility, facility), effective Jul 1, 2013
VA: $4.80 (medical), effective Jul 1, 2008
WY: $0.00 (professional), effective Sep 1, 2017
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.