Alcohol and/or substance abuse services, treatment plan development and/or modification
Medicare coverage: Not payable by Medicare
Status: active (October 2026 file)
Medicare pricing for T1007
Physician Fee Schedule (CY 2026, RVU26D)
Status I: not valid for Medicare (Medicare uses another code).
Payer policies and prior authorization for T1007
Medicaid fee-for-service
Prior authorization required or conditional in IN.
KY: $93.61 (behavioral_health, billed with AF/AM), effective Jul 15, 2026
ND: $0.00 (physician), effective Aug 1, 2026
TX: $40.44 (outpatient_behavioral_health_chemical_dependencytreatment_fa, Outpatient Behavioral Health - Chemical Dependencytreatment Facility, facility), effective Mar 1, 2022
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.