HCPCS Level II › T codes T2002 N-et; per diemNon-emergency transportation; per diem
Medicare coverage: Not payable by Medicare Status: active (October 2026 file) Medicare pricing for T2002 Physician Fee Schedule (CY 2026, RVU26D) Status I: not valid for Medicare (Medicare uses another code).
Payer policies and prior authorization for T2002 9 of 9 payer prior-auth lists that name T2002 require prior authorization or set conditions: Humana, Molina Healthcare of Mississippi, Molina Healthcare of Texas, UnitedHealthcare Community Plan.
Payer Plan State Prior auth Conditions Since Source Humana Humana Healthy Horizons LA prior auth required Jan 1, 2027 Humana Healthy Horizons in Louisiana Prior Authorization and Notification List To Except where noted via links on the following pages, prior authorization requests for medical services may be initiate Molina Healthcare of Mississippi Medicaid MS prior auth required State exception Jan 1, 2025 Mississippi Medicaid Prior Auth (PA) Code Matrix and exceptions, effective Q1 2025 Molina Healthcare of Texas STAR TX prior auth required Feb 19, 2025 Molina Healthcare of Texas Prior Authorization Annual Review Report (STAR), reviewed 2025-02-19 Molina Healthcare of Texas STAR+PLUS TX prior auth required Feb 19, 2025 Molina Healthcare of Texas Prior Authorization Annual Review Report (STAR+PLUS), reviewed 2025-02-19 Molina Healthcare of Texas STAR, STAR+PLUS, STAR Kids, CHIP (Medicaid PA code matrix) TX prior auth required Prescribed Pediatric Extended Care Center (PPECC) Benefit Jan 1, 2022 Medicaid Behavioral Health and Medical Prior Authorization (PA) Code Matrix (Texas), 2026-Q3 UnitedHealthcare Community Plan Louisiana Medicaid (Healthy Louisiana) LA prior auth required Jan 1, 2026 Prior authorization requirements for UnitedHealthcare Community Plan of Louisiana UnitedHealthcare Community Plan MississippiCAN MS prior auth required Apr 1, 2025 Prior authorization requirements for UnitedHealthcare Community Plan of Mississippi – Mississippi Coordinated Access Network (MississippiCAN) Effective Apr. 1, 2025 UnitedHealthcare Community Plan Texas STAR TX prior auth required Oct 1, 2018 Prior authorization requirements for Texas STAR Effective September 1, 2026 This list contains prior authorization review requirements for participating UnitedHealthcare Community Plan of Texas STAR h UnitedHealthcare Community Plan Texas STAR Kids TX prior auth required Oct 1, 2018 Prior authorization requirements for STAR Kids Effective September 1, 2026 This list contains prior authorization review requirements for participating UnitedHealthcare Community Plan of Texas STAR Ki
Payer coverage policies that name T2002 T2002 appears in 2 coverage policies from Blue Cross & Blue Shield of Mississippi, Premera Blue Cross.
Payer Policy Role in policy Reviewed Document Blue Cross & Blue Shield of Mississippi Ambulance And Medical Transport Services (L.9.01.400) covered if criteria are met payer document Premera Blue Cross Non-covered Services and ProceduresPage | 21 of 30 | ∞ not covered Jun 1, 2026 payer document
Medicaid fee-for-service Prior authorization required or conditional in IN, MS.
IN: $22.54 (professional, Advanced Practice Nurse (85%), non-facility), effective Jul 1, 2023 KS: $15.00 (default), effective Jan 15, 2008 MS: $42.45 (comprehensive), effective Jul 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.