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PAYER POLICY CHANGES

T2028 Insurance Policy Changes

HCPCS T2028 is officially defined as "Specialized supply, not otherwise specified, waiver." HCPCS T2028 is referenced in 1 tracked payer policy change from Michigan Medicaid - MDHHS. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS T2028 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

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REFERENCE DATA

Payers with rules8
Payers requiring prior auth8
  • BCBS Illinois · Effective October 1, 2026

    Prior authorization required in some cases

    Blue Cross Community Health Plans (Illinois Medicaid) Prior Authorization Code List

  • Anthem BCBS · Effective February 11, 2026

    Prior authorization required

    List of items and services that require prior authorization (Medicaid NY)

  • Elevance Health · Effective February 11, 2026

    Prior authorization required

    List of items and services that require prior authorization (Medicaid TX)

FREQUENTLY ASKED QUESTIONS

Does Ambetter require prior authorization for T2028?

Ambetter lists T2028 on Ambetter from Arizona Complete Health CMS-0057-F prior authorization requirements for exchange plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does AmeriHealth Caritas require prior authorization for T2028?

AmeriHealth Caritas lists T2028 on AmeriHealth Caritas Louisiana prior authorization service list for medicaid managed plans. Verify with the payer before scheduling.

Does Anthem BCBS require prior authorization for T2028?

Anthem BCBS lists T2028 on List of items and services that require prior authorization (Medicaid NY) for medicaid managed plans (list dated February 11, 2026). Verify with the payer before scheduling.

Does BCBS Illinois require prior authorization for T2028?

BCBS Illinois lists T2028 on Blue Cross Community Health Plans (Illinois Medicaid) Prior Authorization Code List for medicaid managed plans, with conditions (list dated October 1, 2026). Verify with the payer before scheduling.

Does Carolina Complete Health require prior authorization for T2028?

Carolina Complete Health lists T2028 on Carolina Complete Health CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

What insurance policy changes affect HCPCS T2028?

There are 1 tracked policy change affecting HCPCS T2028, including updates from Michigan Medicaid - MDHHS. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS T2028?

Payers that have issued tracked updates for HCPCS T2028 include: Michigan Medicaid - MDHHS.

How do I get notified when HCPCS T2028 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS T2028. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for HCPCS T2028?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

See every payer rule for T2028

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for T2028 in one place.

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