T1012 Alcohol/substance abuse skil

Alcohol and/or substance abuse services, skills development

Medicare pricing for T1012

Physician Fee Schedule (CY 2026, RVU26D)

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

Payer policies and prior authorization for T1012

4 of 4 payer prior-auth lists that name T1012 require prior authorization or set conditions: Humana, Molina Complete Care (Virginia).

PayerPlanStatePrior authConditionsSinceSource
HumanaHumana D-SNP (VA)VAprior auth requiredJan 1, 2027Virginia Prior Authorization and Notification List
HumanaHumana Healthy HorizonsVAprior auth requiredJan 1, 2027Humana Healthy Horizons in Virginia Prior Authorization and Notification List (PAL)
Molina Complete Care (Virginia)Virginia state exceptions to the national Medicaid grid (exceptions only)VAprior auth requiredState exceptionApr 1, 2025Virginia Medicaid PA Code Matrix and Virginia code/benefit exceptions, effective Q2 2025
Molina Complete Care (Virginia)MedicaidVAprior auth requiredState exceptionApr 1, 2025Virginia Medicaid PA Code Matrix and Virginia code/benefit exceptions, effective Q2 2025

Recent prior-auth changes

  • Jan 1, 2027: PA added, Humana

Medicaid fee-for-service

Prior authorization required or conditional in IN, VA.

  • ND: $0.00 (physician), effective Aug 1, 2026
  • VA: $14.30 (medical), effective Jan 1, 2024
  • 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.