`T1503` Med admin, not oral/inject

Administration of medication, other than oral and/or injectable, by a health care agency/professional, per visit

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

Medicare pricing for T1503

Physician Fee Schedule (CY 2026, RVU26D)

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

Payer policies and prior authorization for T1503

7 of 7 payer prior-auth lists that name T1503 require prior authorization or set conditions: Blue Cross and Blue Shield of Texas, Humana.

Payer	Plan	State	Prior auth	Conditions	Since	Source
Blue Cross and Blue Shield of Texas	Texas PA exemption (gold card), outpatient, fully insured	TX	prior auth required	Gold-card exemption available	Jul 1, 2026	BCBSTX Outpatient Prior Authorization Exemption Clinical Guidelines (max units, PA exempt date range)
Humana	Humana D-SNP (FL)	FL	prior auth required		Jan 1, 2027	1 *New prior authorization requirement 787403FL0725 FLHMQSREN Humana Dual Fully Integrated Florida Prior Authorization and Notification List
Humana	Humana D-SNP (IL)	IL	prior auth required		Jan 1, 2027	Humana Dual Fully Integrated Illinois Prior Authorization and Notification 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	Oak Street Health	All	prior auth required			Oak Street Health (Humana): Prior Authorization List (PAL) Codes Under Management

Payer coverage policies that name T1503

T1503 appears in 1 coverage policy from Aetna.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Esketamine (Spravato) (0950)	covered if criteria are met	Feb 25, 2026	payer document

Recent prior-auth changes

Jan 1, 2024: PA removed, humana:pa:commercial

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.

T1503 Med admin, not oral/inject