HCPCS Level II T1020: Personal Care Services, Per Diem

HCPCS Level II code T1020 describes personal care services, per diem provided as part of an individualized plan of treatment for patients who are not inpatients or residents of a hospital, nursing facility, ICF/MR, or IMD; the service type is personal care assistance and the typical site of service is community- or home-based non-institutional settings where daily personal care tasks are delivered under a treatment plan.

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HCPCS Level II T1020: Personal Care Services, Per Diem

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Get alerted when payer policies referencing T1020 are released or updated.

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Clinical & Coding Specifications

Clinical Context

A typical patient is an adult living independently in the community who requires scheduled, non-skilled assistance with activities of daily living (ADLs) and instrumental ADLs (IADLs) as part of an individualized plan of treatment. The patient may have chronic functional limitations from conditions such as advanced osteoarthritis, chronic obstructive pulmonary disease, stroke-related hemiparesis, Parkinson disease, or persistent fatigue from cancer treatment that interfere with safe performance of bathing, dressing, toileting, meal preparation, medication reminders, and mobility transfers.

The clinical workflow begins with a treating clinician (primary care physician, geriatrician, physiatrist, or nurse practitioner) documenting functional deficits and an individualized plan of treatment that specifies daily personal care services. A home care agency or social services case manager authorizes and schedules per diem personal care visits provided by non-skilled personal care workers (not home health aides or CNAs under this code). Progress notes document adherence to the individualized plan, changes in function, and any referrals for skilled services if the patient’s needs escalate. Billing uses T1020 on a per diem basis for covered payors, with appropriate modifier(s) appended when required by payor policy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99304`	Initial nursing facility care, per day, for the evaluation and management of a patient — typically 18–29 minutes	May be used by clinicians documenting an initial comprehensive evaluation that justifies placement on an individualized plan of treatment that includes `T1020` personal care services when performed in an institutional setting; often used in pre-placement assessments.
`99307`	Subsequent nursing facility care, per day, for the evaluation and management of a patient — typically 5–11 minutes	May be used for periodic medical follow-up visits that assess continued need for per diem personal care under the individualized plan.
`99509`	Home care supervision services, per hour	Often billed for non-direct supervisory clinical services associated with coordinating personal care staff and monitoring adherence to the individualized plan; can be part of the overall care episode.
`96127`	Brief emotional/behavioral assessment (e.g., depression inventory)	Used when screening for cognitive or mood disorders that affect the patient’s ability to participate in ADLs and support the need for personal care services.
`G0156`	Services of home health aide in home health setting, per 15 minutes — used by Medicare for some home health aide services	Billed by Medicare in home health episodes for skilled aide services; `T1020` is distinct and used for non-skilled personal care per diem — both may appear in the same clinical workflow but are billed to different payors or benefit structures.

Related Modifiers

6 rows

Modifier	Description	When to Use
22	Modifier –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…
23	Modifier -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…
52	Modifier ‑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…
53	Modifier 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…
55	Modifier –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…
62	Modifier 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	Specialty	Notes
208D00000X	General Practice Physician	A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
207Q00000X	Family Medicine Physician	Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
2471Q0001X	Quality Management Radiologic Technologist	A radiologic technologist who specializes in quality management.
3336H0001X	Home Infusion Therapy Pharmacy	Pharmacy-based, decentralized patient care organization with expertise in USP 797-compliant sterile drug compounding that provides care to patients wi…
163WW0000X	Wound Care Registered Nurse	Nursing Service Providers · Registered Nurse
283Q00000X	Psychiatric Hospital	An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients r…
231HA2500X	Assistive Technology Supplier Audiologist	Speech, Language and Hearing Service Providers · Audiologist
2080A0000X	Pediatric Adolescent Medicine Physician	A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and …

Related ICD-10-CM Codes

25 rows

ICD-10-CM Code	Description
F01.50	Vascular dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F03.90	Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
G30.9	Alzheimer's disease, unspecified
G31.84	Mild cognitive impairment of uncertain or unknown etiology
G82.20	Paraplegia, unspecified
M25.50	Pain in unspecified joint
M25.561	Pain in right knee
M25.562	Pain in left knee
M62.50	Muscle wasting and atrophy, not elsewhere classified, unspecified site
M62.81	Muscle weakness (generalized)

Showing 1–10 of 25

Related Payer Policy Updates

Specialty: Durable Medical Equipment (DME)1 / 2

10 rows

Policy	Payer	Effective Date
Prior Authorization for Durable Medical Equipment (DME)	Blue Cross Blue Shield - Rhode Island	2026-10-01
Continuous Passive Motion (CPM) Devices	Cigna	2026-08-15
Push-Rim Activated Power-Assist Device (E0986) — Manual Wheelchair Accessory	moda_health_plan_inc	2026-08-13
Beds and Mattresses (for Ohio Only)	Colorado Rocky Mountain Health Plans	2026-08-01
Beds and Mattresses (for Kentucky Only)	UnitedHealthcare	2026-08-01
Pneumatic Compression Devices (for Nebraska Only)	UnitedHealthcare	2026-08-01
Indications for Coverage — Hospital beds, support surfaces, and safety enclosure beds (DME)	Colorado Rocky Mountain Health Plans	2026-08-01
Pediatric Gait Trainers and Standing Systems (for Tennessee Only)	UnitedHealthcare	2026-08-01
Enteral Nutrition (Oral and Tube Feeding) (for Pennsylvania Only)	UnitedHealthcare	2026-08-01
Beds and Mattresses (for Kansas Only)	UnitedHealthcare	2026-08-01

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

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

Showing 1–10 of 113

Frequently Asked Questions

References

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.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.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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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.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99304`	Initial nursing facility care, per day, for the evaluation and management of a patient — typically 18–29 minutes	May be used by clinicians documenting an initial comprehensive evaluation that justifies placement on an individualized plan of treatment that includes `T1020` personal care services when performed in an institutional setting; often used in pre-placement assessments.
`99307`	Subsequent nursing facility care, per day, for the evaluation and management of a patient — typically 5–11 minutes	May be used for periodic medical follow-up visits that assess continued need for per diem personal care under the individualized plan.
`99509`	Home care supervision services, per hour	Often billed for non-direct supervisory clinical services associated with coordinating personal care staff and monitoring adherence to the individualized plan; can be part of the overall care episode.
`96127`	Brief emotional/behavioral assessment (e.g., depression inventory)	Used when screening for cognitive or mood disorders that affect the patient’s ability to participate in ADLs and support the need for personal care services.
`G0156`	Services of home health aide in home health setting, per 15 minutes — used by Medicare for some home health aide services	Billed by Medicare in home health episodes for skilled aide services; `T1020` is distinct and used for non-skilled personal care per diem — both may appear in the same clinical workflow but are billed to different payors or benefit structures.

Related Modifiers

6 rows

Modifier	Description	When to Use
22	Modifier –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…
23	Modifier -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…
52	Modifier ‑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…
53	Modifier 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…
55	Modifier –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…
62	Modifier 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	Specialty	Notes
208D00000X	General Practice Physician	A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
207Q00000X	Family Medicine Physician	Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
2471Q0001X	Quality Management Radiologic Technologist	A radiologic technologist who specializes in quality management.
3336H0001X	Home Infusion Therapy Pharmacy	Pharmacy-based, decentralized patient care organization with expertise in USP 797-compliant sterile drug compounding that provides care to patients wi…
163WW0000X	Wound Care Registered Nurse	Nursing Service Providers · Registered Nurse
283Q00000X	Psychiatric Hospital	An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients r…
231HA2500X	Assistive Technology Supplier Audiologist	Speech, Language and Hearing Service Providers · Audiologist
2080A0000X	Pediatric Adolescent Medicine Physician	A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and …

Related ICD-10-CM Codes

25 rows

ICD-10-CM Code	Description
F01.50	Vascular dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F03.90	Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
G30.9	Alzheimer's disease, unspecified
G31.84	Mild cognitive impairment of uncertain or unknown etiology
G82.20	Paraplegia, unspecified
M25.50	Pain in unspecified joint
M25.561	Pain in right knee
M25.562	Pain in left knee
M62.50	Muscle wasting and atrophy, not elsewhere classified, unspecified site
M62.81	Muscle weakness (generalized)

Showing 1–10 of 25

Related Payer Policy Updates

Specialty: Durable Medical Equipment (DME)1 / 2

10 rows

Policy	Payer	Effective Date
Prior Authorization for Durable Medical Equipment (DME)	Blue Cross Blue Shield - Rhode Island	2026-10-01
Continuous Passive Motion (CPM) Devices	Cigna	2026-08-15
Push-Rim Activated Power-Assist Device (E0986) — Manual Wheelchair Accessory	moda_health_plan_inc	2026-08-13
Beds and Mattresses (for Ohio Only)	Colorado Rocky Mountain Health Plans	2026-08-01
Beds and Mattresses (for Kentucky Only)	UnitedHealthcare	2026-08-01
Pneumatic Compression Devices (for Nebraska Only)	UnitedHealthcare	2026-08-01
Indications for Coverage — Hospital beds, support surfaces, and safety enclosure beds (DME)	Colorado Rocky Mountain Health Plans	2026-08-01
Pediatric Gait Trainers and Standing Systems (for Tennessee Only)	UnitedHealthcare	2026-08-01
Enteral Nutrition (Oral and Tube Feeding) (for Pennsylvania Only)	UnitedHealthcare	2026-08-01
Beds and Mattresses (for Kansas Only)	UnitedHealthcare	2026-08-01

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

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

Showing 1–10 of 113

Frequently Asked Questions

References

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.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.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.

Published by

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

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HCPCS Level II T1020: Personal Care Services, Per Diem

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OpenPayer

HCPCS Level II T1020: Personal Care Services, Per Diem

Sign up for hcpcs T1020 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

HCPCS Level II T1020: Personal Care Services, Per Diem

Sign up for hcpcs T1020 policy alerts

HCPCS Level II T1020: Personal Care Services, Per Diem

Sign up for hcpcs T1020 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What does HCPCS code T1020 represent and where is it typically used?

Which payers commonly cover T1020 and how is it billed?

When should modifiers be used with T1020 and which modifiers are relevant?

What clinical situations and workflow justify using T1020?

How does T1020 relate to other billing codes like G0156, 99509, or E/M CPT codes?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What does HCPCS code T1020 represent and where is it typically used?

Which payers commonly cover T1020 and how is it billed?

When should modifiers be used with T1020 and which modifiers are relevant?

What clinical situations and workflow justify using T1020?

How does T1020 relate to other billing codes like G0156, 99509, or E/M CPT codes?

References