`H2031` Mh clubhouse svc, per diem

Mental health clubhouse services, per diem

Medicare coverage: Not payable by Medicare
Status: active (October 2026 file)

Medicare pricing for H2031

Physician Fee Schedule (CY 2026, RVU26D)

Status I: not valid for Medicare (Medicare uses another code).

Payer policies and prior authorization for H2031

1 of 1 payer prior-auth lists that name H2031 require prior authorization or set conditions: Molina Healthcare of Iowa.

Payer	Plan	State	Prior auth	Conditions	Since	Source
Molina Healthcare of Iowa	Medicaid	IA	prior auth required		Jul 1, 2023	IA Prior Authorization Matrix, effective Q3 2023

Payer coverage policies that name H2031

H2031 appears in 2 coverage policies from Aetna, Premera Blue Cross.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Home Behavioral Healthcare Services (0730)	listed, no stance	Nov 26, 2025	payer document
Premera Blue Cross	Non-covered Services and Procedures Page \| 17 of 30 \| ∞	not covered	Jun 1, 2026	payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

ND: $0.00 (physician), effective Aug 1, 2026

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.

H2031 Mh clubhouse svc, per diem