H2019 Ther behav svc, per 15 minTherapeutic behavioral services, per 15 minutes
Status I: not valid for Medicare (Medicare uses another code).
11 of 14 payer prior-auth lists that name H2019 require prior authorization or set conditions: Blue Shield of California, Blue Shield of California Promise Health Plan, Humana, Molina Healthcare of California, Molina Healthcare of Iowa, Passport by Molina Healthcare (Kentucky).
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Blue Shield of California | Blue Shield commercial | CA | prior auth required | Sep 1, 2026 | Prior Authorization List for Blue Shield | |
| Blue Shield of California Promise Health Plan | Promise Health Plan Medi-Cal | CA | prior auth required | Sep 1, 2026 | Medi-Cal Prior Authorization List | |
| Humana | Humana D-SNP (SC) | SC | prior auth required | Jan 1, 2027 | Humana Dual Highly Integrated South Carolina Prior Authorization and Notification List | |
| Humana | Humana Healthy Horizons | FL | prior auth required | Jan 1, 2027 | 1102002FL1026 FLHN8CBEN Humana Healthy Horizons in Florida Preauthorization and Notification List | |
| Humana | Humana Healthy Horizons | KY | prior auth required | Jan 1, 2027 | please visit Humana Healthy Horizons in Kentucky Clinical coverage policies. | |
| Humana | Humana Healthy Horizons | OH | prior auth required | Jan 1, 2027 | 555201OH0924-B OHHMZG2EN Humana Healthy Horizons® in Ohio Prior Authorization Notification List (PAL) The following preauthorization and notification list | |
| Molina Healthcare of California | California state exceptions (exceptions only) | CA | prior auth required | State exception | Jul 1, 2021 | California PA code exceptions (Marketplace), Q3 2021 |
| Molina Healthcare of California | California state exceptions (exceptions only) | CA | prior auth required | State exception | Jul 1, 2021 | California PA code exceptions (Medi-Cal), Q3 2021 |
| Molina Healthcare of California | Medicaid | CA | prior auth required | State exception | Apr 1, 2026 | Medicaid Prior Auth (PA) Code Matrix (California), effective Q2 2026 |
| Molina Healthcare of Iowa | Medicaid | IA | prior auth required | Jul 1, 2023 | IA Prior Authorization Matrix, effective Q3 2023 | |
| Passport by Molina Healthcare (Kentucky) | Medicaid | KY | prior auth required | Jul 1, 2026 | Kentucky Medicaid Prior Auth (PA) Code Matrix and Kentucky PA Code Exceptions, effective Q3 2026 |
H2019 appears in 6 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Rhode Island, Blue Shield of California, Premera Blue Cross.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Home Behavioral Healthcare Services (0730) | listed, no stance | Nov 26, 2025 | payer document |
| Anthem | Intensive In-home Behavioral Health Services (CG-BEH-14) | covered if criteria are met | Nov 6, 2025 | payer document |
| Blue Cross & Blue Shield of Rhode Island | Autism Spectrum Disorders Mandate PAYMENT POLICY | 4 | covered if criteria are met | Apr 15, 2026 | payer document |
| Blue Shield of California | Applied Behavior Analysis for Autism Spectrum Disorder or BSC3.01 Pervasive Developmental Disorder | listed, no stance | payer document | |
| Blue Shield of California | Behavioral Health Treatment for Autism Spectrum Disorder or BSC3.01 Pervasive Developmental Disorder | listed, no stance | payer document | |
| Premera Blue Cross | Applied Behavior Analysis (ABA) (3.01.510) | listed, no stance | Apr 27, 2026 | payer document |
Prior authorization required or conditional in IN, VA.
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.