`T2020` Day habil waiver per diem

Day habilitation, waiver; per diem

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

Medicare pricing for T2020

Physician Fee Schedule (CY 2026, RVU26D)

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

Payer policies and prior authorization for T2020

6 of 6 payer prior-auth lists that name T2020 require prior authorization or set conditions: Blue Cross and Blue Shield of Illinois, Humana, Molina Healthcare of California, Molina Healthcare of Iowa, UnitedHealthcare Community Plan.

Payer	Plan	State	Prior auth	Conditions	Since	Source
Blue Cross and Blue Shield of Illinois	Blue Cross Community Health Plans (BCCHP), Illinois Medicaid	IL	prior auth required		Jan 1, 2026	Illinois Medicaid Prior Authorization Code List, Effective 10/1/2026
Blue Cross and Blue Shield of Illinois	Blue Cross Community MMAI (Medicare-Medicaid Alignment Initiative)	IL	prior auth required		Jan 1, 2025	Procedure Code List, Effective 1/1/2025
Humana	Humana LTSS (Dual/integrated plan)	IL	prior auth required		Jan 1, 2027	Humana Dual Fully Integrated (HMO D-SNP) Illinois long-term services and supports prior authorization and notification list
Molina Healthcare of California	Medicaid	CA	prior auth required	State exception	Apr 1, 2026	Medicaid Prior Auth (PA) Code Matrix (California), effective Q2 2026
Molina Healthcare of Iowa	Medicaid	IA	prior auth required		Jul 1, 2023	IA Prior Authorization Matrix, effective Q3 2023
UnitedHealthcare Community Plan	Massachusetts Senior Care Options (SCO) and OneCare	MA	prior auth required		Oct 1, 2026	Prior authorization requirements for Massachusetts MA SCO OneCare Effective October 1, 2026

Payer coverage policies that name T2020

T2020 appears in 1 coverage policy from Premera Blue Cross.

Payer	Policy	Role in policy	Reviewed	Document
Premera Blue Cross	Non-covered Services and Procedures Page \| 21 of 30 \| ∞	not covered	Jun 1, 2026	payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

IN: $11.29 (professional, Advanced Practice Nurse (85%), non-facility), effective Jul 1, 2023
WY: $67.70 (professional), effective Oct 1, 2023

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.

T2020 Day habil waiver per diem