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    v1.0.30
    OpenPayerBilling CodesNational Codes Established for State Medicaid AgenciesHCPCS hcpcs-level-ii-t1030-nursing-care-home-registered-nurse-per-diem
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    HCPCS Level II T1030: Nursing Care in Home by Registered Nurse, Per Diem

    HCPCS Level II code T1030 represents nursing care, in the home, by a registered nurse, billed per diem, describing episodic skilled nursing provided by an RN as a home health service; the service type is skilled nursing care and the typical site of service is the patient's home (home health or home-based care setting).

    For related coverage guidance, see recent payer policy updates: Hospital Beds Corporate Medical Policy, Patient Lifts, Home Non-Invasive Positive Pressure Ventilation (NIPPV) Devices for Respiratory Insufficiency and Failure.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A homebound adult patient with multiple chronic conditions (for example, congestive heart failure, chronic obstructive pulmonary disease, and limited mobility) receives skilled nursing assessment and treatment delivered by a registered nurse in the patient’s residence. The RN documents a comprehensive per diem plan of care that includes medication teaching, wound inspection and dressing changes, intravenous access assessment, vital signs monitoring, and caregiver education. Visits are coordinated through a home health agency; the RN arrives at the scheduled time, performs the ordered skilled services, records findings in the home health record, communicates changes to the referring physician, and updates the interdisciplinary plan of care. Billing is submitted using T1030 to report nursing care, in the home, by a registered nurse, per diem, with appropriate modifier(s) attached when specific circumstances apply (for example, unusual services, concurrent billing situations, or telehealth attachments). Care coordination often involves communication with primary care, home health aides, physical therapy, and durable medical equipment suppliers as clinically indicated.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99507Home visit for collection of specimens (blood, urine) by medical personnelRN may collect specimens during the per diem home visit and documentation supports specimen collection billing when applicable
    99211Office or other outpatient visit for the evaluation and management of an established patient, minimal problemsLow-complexity nursing assessments documented during the home visit can correspond to services similar in intensity to 99211 when local billing policies permit
    96365Intravenous infusion, initial, up to 1 hourRN-delivered IV medication administration in the home may be billed alongside per diem nursing when payor rules permit separate infusion service billing
    97597Debridement, open wound, first 20 sq cm or lessSkilled wound debridement performed by an RN during a home visit may be billed when documentation meets clinical and payor requirements
    99499Unlisted evaluation and management serviceUse for reporting additional unique skilled services performed in the home that are not described by other CPT codes when allowed by payor policy

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    56Modifier ‑56 indicates the reporting provider furnished only the preoperative management for a surgical procedure and did not perform the intraoperative or postoperative care. It is used in…- Use Modifier -56 when a provider performs only the preoperative management in a split‑care situation (one physician manages preop care while a different physician performs the intraoperative…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    163W00000X
    174400000X
    347E00000X
    133VN1501X
    2084H0002X
    174N00000X
    2278P1006X
    311500000X

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 2

    10 rows

    PolicyPayerEffective Date
    Hospital Beds Corporate Medical Policybcbsvermont2027-01-01
    Patient Liftsuniverahealthcare2026-11-16
    Home Non-Invasive Positive Pressure Ventilation (NIPPV) Devices for Respiratory Insufficiency and Failureexcellus_health_plan_inc2026-10-15
    Positive Airway Pressure Devices for Pulmonary Disorders Continued RentalCareSource Georgia2026-10-01
    Bone Growth StimulatorsProvidence Health Plan2026-10-01
    Durable Medical Equipment (DME) Medical Necessity and CoverageMass General Brigham Health Plan2026-10-01
    Speech Generating DevicesMass General Brigham Health Plan2026-10-01
    Interferential Stimulation Devices (for home use)Moda Health2026-10-01
    Durable Medical Equipment (DME): Tumor Treating Fields (Alternating Electric Field Therapy) Medical GuidelineWPS Health Insurance2026-10-01
    Durable Medical Equipment (DME): Bone Growth Stimulators Medical GuidelineWPS Health Insurance2026-10-01

    Related Codes

    HCPCS-LEVEL-II-T2014-PREVOCATIONAL-HABILITATION-PER-DIEM

    HCPCS Level II T2014: Habilitation, Prevocational, Waiver; Per Diem

    HCPCS-LEVEL-II-T2020-DAY-HABILITATION-WAIVER-PER-DIEM

    HCPCS Level II T2020: Day Habilitation, Waiver; Per Diem

    HCPCS-LEVEL-II-T2047-HABILITATION-PREVOCATIONAL-WAIVER

    HCPCS Level II T2047: Habilitation Prevocational Waiver, per 15 minutes

    HCPCS-LEVEL-II-T4535-DISPOSABLE-INCONTINENCE-LINER-PAD

    HCPCS Level II T4535: Disposable Incontinence Liner/Pad

    HCPCS-LEVEL-II-T4538-REUSABLE-DIAPER-PER-DIAPER

    HCPCS Level II T4538: Reusable Diaper, Each

    HCPCS-T1000-PRIVATE-DUTY-LICENSED-NURSING-15-MIN

    HCPCS Level II T1000: Private Duty Licensed Nursing, up to 15 Minutes

    HCPCS-T1001-NURSING-ASSESSMENT-EVALUATION

    HCPCS Level II T1001: Nursing Assessment/Evaluation

    HCPCS-T1002-RN-SERVICES-15-MINUTES

    HCPCS T1002: RN Services, Up to 15 Minutes

    HCPCS-T1003-LPN-LVN-SERVICES-15-MINUTES

    HCPCS Level II T1003: LPN/LVN Services, Up to 15 Minutes

    HCPCS-T1004-NURSING-AIDE-15-MINUTE-SERVICE

    HCPCS Level II T1004: Services of a Qualified Nursing Aide, up to 15 Minutes

    Showing 1–10 of 113

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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