T1026 HCPCS code: Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per hour
T1026 is the HCPCS Level II code for intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per hour. Its Medicare coverage code is I (Not payable by Medicare): Medicare does not pay separately under this code; another code applies.
Code details
| Field | Value |
|---|---|
| Section | T codes — National codes established for state Medicaid agencies |
| Coverage code | I — Not payable by Medicare |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | Z2 |
| Added | 2003-01-01 |
| Last action effective | 2024-01-01 |
What changed for T1026
- 2003-01-01: T1026 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code T1026?
T1026 is the HCPCS Level II code for intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per hour. Short descriptor: "Ped compr care pkg, per hour".
Does Medicare cover T1026?
Coverage code I — Not payable by Medicare. Medicare does not pay separately under this code; another code applies.
Related T10 codes
- T1000 — Private duty / independent nursing service(s) - licensed, up to 15 minutes
- T1001 — Nursing assessment / evaluation
- T1002 — Rn services, up to 15 minutes
- T1003 — Lpn/lvn services, up to 15 minutes
- T1004 — Services of a qualified nursing aide, up to 15 minutes
- T1005 — Respite care services, up to 15 minutes
- T1006 — Alcohol and/or substance abuse services, family/couple counseling
- T1007 — Alcohol and/or substance abuse services, treatment plan development and/or modification
- T1009 — Child sitting services for children of the individual receiving alcohol and/or substance abuse services
- T1010 — Meals for individuals receiving alcohol and/or substance abuse services (when meals not included in the program)
- T1012 — Alcohol and/or substance abuse services, skills development
- T1013 — Sign language or oral interpretive services, per 15 minutes
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Next steps
- Run a reimbursement report for a device billed under T1026
- Watch T1026 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for T1026
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.