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HCPCS Level II T1030: Nursing Care in Home by Registered Nurse, Per Diem

HCPCS Level II code T1030 designates per diem skilled nursing care provided by a registered nurse in the patients home. This code is used to bill episodic, day-based home nursing services and is a key identifier for tracking utilization of skilled home nursing nationally. Home-based skilled nursing supports transitions from institutional care, ongoing chronic disease management, and efforts to reduce avoidable hospital visits.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a national perspective on how T1030 is applied across major commercial payers and Medicare, along with benchmarking context, relevant policy issues affecting home nursing reimbursement, and the clinical situations where per diem registered nurse services are typically billed. The publication covers billing practice considerations, common modifier use (listed separately), and where available, payer-specific coverage patterns and documentation expectations.

This summary provides stakeholders—billing professionals, home health agencies, and policy analysts—with an overview of the codes purpose, its role in home-based skilled care, and the topics addressed in the full publication, including benchmarks, policy updates, and clinical context. Data not available in the input will be noted in the detailed sections.

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Billing Code Overview

HCPCS Level II code T1030 represents nursing care, in the home, by registered nurse, per diem. This service covers skilled nursing provided by a registered nurse delivered in a patients home setting on a per-day basis. The service type is skilled nursing care. The typical site of service is the patients home or residence.

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HCPCS Level II T1030: Nursing Care in Home by Registered Nurse, Per Diem

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Billing Code Overview

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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.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier	Used when no additional billing modifier applies to the per diem service
`22`	Increased procedural services	Use when the RN provides substantially greater than normal services during the per diem that are documented and meet payor criteria
`23`	Unusual anesthesia	Not typically used for `T1030`; included if an unusual anesthesia circumstance is documented and required by payor (rare)
`52`	Reduced services	Use when the per diem nursing visit is partially performed or curtailed and documentation supports reduced service
`53`	Discontinued procedure	Use if the per diem nursing service was initiated but discontinued for documented clinical reasons
`55`	Postoperative management only	Use when the RN documents only postoperative management activities covered under the per diem without other skilled procedures
`56`	Preoperative management only	Rare for home RN per diem; use if only preoperative management is provided in the home setting
`62`	Two surgeons	Not typical for home RN per diem; apply only if an unusual billing arrangement applies per payor guidance
`AS`	Physician assistant, surgical assist	Not typical for `T1030`; include when billing systems require an assist modifier for concurrent provider roles
`CO`	Cast care (example) / Contracted care indicator	Use per payor definition where a contract-specific modifier is required to indicate contracted provider relationships
`CQ`	Service furnished as part of a public health emergency	Use when per diem nursing care is provided under public health emergency provisions and the payor requires this modifier
`FY`	Item or service furnished by resident without faculty	Not typical for home RN per diem; include when supervised trainees provide the service and payor requires this indicator
`GT`	Via interactive audio and video telecommunication systems	Use when portions of the nursing per diem include synchronous telehealth nursing services and the payor accepts `GT` with `T1030`
`QX`	Qualified non-physician practitioner billing under their own NPI	Use when a qualifying non-physician practitioner bills independently for nursing-related services tied to the per diem encounter
`QY`	Attending surgeon or billing practitioner	Use if payor requires designation of the primary billing practitioner in complex care coordination scenarios

Taxonomy Code	Specialty	Notes
`163W00000X`	Home Health Registered Nurse	Primary provider type performing `T1030` services in the home setting
`163WF0200X`	Wound care nurse	RN specialty commonly providing skilled wound assessment and dressing changes during per diem visits
`163WH0000X`	Hospice and Palliative Care Nurse	RN specialty providing home per diem nursing for end-of-life symptom management
`174400000X`	Physical Therapist (PT)	Commonly collaborates with RN in home care; may not bill `T1030` but is part of the care team
`261QM0800X`	Case Manager Nurse	Coordinates visits, communicates with payors and physicians for home per diem services

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I50.9`	Heart failure, unspecified	Common reason for home nursing visits for monitoring weight, medication adherence, and symptoms
`J44.9`	Chronic obstructive pulmonary disease, unspecified	Home RN monitors respiratory status, oxygen use, and teaches inhaler/oxygen techniques
`Z74.3`	Need for continuous supervision	Indicates functional limitations that justify home nursing per diem services
`Z79.899`	Other long term (current) drug therapy	Documents chronic medication regimens that require RN medication education and monitoring in the home
`L89.309`	Pressure ulcer of sacral region, stage 3, unspecified	Wound care and dressing changes are common skilled tasks performed during per diem nursing visits

Related CPT Codes

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

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 Service

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: Diaper Service, Reusable Diaper, Each Diaper

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

HCPCS T1000: Private Duty Licensed Nursing, 15-Minute Units

HCPCS-T1001-NURSING-ASSESSMENT-EVALUATION

HCPCS T1001: Nursing Assessment / Evaluation

HCPCS-T1002-RN-SERVICES-15-MINUTES

HCPCS T1002: Registered Nurse Services, Up to 15 Minutes

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

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

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

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

Showing 1–10 of 113

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

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Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier	Used when no additional billing modifier applies to the per diem service
`22`	Increased procedural services	Use when the RN provides substantially greater than normal services during the per diem that are documented and meet payor criteria
`23`	Unusual anesthesia	Not typically used for `T1030`; included if an unusual anesthesia circumstance is documented and required by payor (rare)
`52`	Reduced services	Use when the per diem nursing visit is partially performed or curtailed and documentation supports reduced service
`53`	Discontinued procedure	Use if the per diem nursing service was initiated but discontinued for documented clinical reasons
`55`	Postoperative management only	Use when the RN documents only postoperative management activities covered under the per diem without other skilled procedures
`56`	Preoperative management only	Rare for home RN per diem; use if only preoperative management is provided in the home setting
`62`	Two surgeons	Not typical for home RN per diem; apply only if an unusual billing arrangement applies per payor guidance
`AS`	Physician assistant, surgical assist	Not typical for `T1030`; include when billing systems require an assist modifier for concurrent provider roles
`CO`	Cast care (example) / Contracted care indicator	Use per payor definition where a contract-specific modifier is required to indicate contracted provider relationships
`CQ`	Service furnished as part of a public health emergency	Use when per diem nursing care is provided under public health emergency provisions and the payor requires this modifier
`FY`	Item or service furnished by resident without faculty	Not typical for home RN per diem; include when supervised trainees provide the service and payor requires this indicator
`GT`	Via interactive audio and video telecommunication systems	Use when portions of the nursing per diem include synchronous telehealth nursing services and the payor accepts `GT` with `T1030`
`QX`	Qualified non-physician practitioner billing under their own NPI	Use when a qualifying non-physician practitioner bills independently for nursing-related services tied to the per diem encounter
`QY`	Attending surgeon or billing practitioner	Use if payor requires designation of the primary billing practitioner in complex care coordination scenarios

Taxonomy Code	Specialty	Notes
`163W00000X`	Home Health Registered Nurse	Primary provider type performing `T1030` services in the home setting
`163WF0200X`	Wound care nurse	RN specialty commonly providing skilled wound assessment and dressing changes during per diem visits
`163WH0000X`	Hospice and Palliative Care Nurse	RN specialty providing home per diem nursing for end-of-life symptom management
`174400000X`	Physical Therapist (PT)	Commonly collaborates with RN in home care; may not bill `T1030` but is part of the care team
`261QM0800X`	Case Manager Nurse	Coordinates visits, communicates with payors and physicians for home per diem services

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I50.9`	Heart failure, unspecified	Common reason for home nursing visits for monitoring weight, medication adherence, and symptoms
`J44.9`	Chronic obstructive pulmonary disease, unspecified	Home RN monitors respiratory status, oxygen use, and teaches inhaler/oxygen techniques
`Z74.3`	Need for continuous supervision	Indicates functional limitations that justify home nursing per diem services
`Z79.899`	Other long term (current) drug therapy	Documents chronic medication regimens that require RN medication education and monitoring in the home
`L89.309`	Pressure ulcer of sacral region, stage 3, unspecified	Wound care and dressing changes are common skilled tasks performed during per diem nursing visits

Related CPT Codes

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

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 Service

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: Diaper Service, Reusable Diaper, Each Diaper

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

HCPCS T1000: Private Duty Licensed Nursing, 15-Minute Units

HCPCS-T1001-NURSING-ASSESSMENT-EVALUATION

HCPCS T1001: Nursing Assessment / Evaluation

HCPCS-T1002-RN-SERVICES-15-MINUTES

HCPCS T1002: Registered Nurse Services, Up to 15 Minutes

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

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

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

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

Showing 1–10 of 113

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

HCPCS Level II T1030: Nursing Care in Home by Registered Nurse, Per Diem

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Billing Code Overview

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HCPCS Level II T1030: Nursing Care in Home by Registered Nurse, Per Diem

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References