Summary & Overview
HCPCS T1024: Integrated Specialty Team Evaluation and Treatment for Severely Handicapped Children
HCPCS Level II code T1024 designates a per-encounter service for evaluation and treatment by an integrated specialty team contracted to provide coordinated care to multiple or severely handicapped children. This code captures multidisciplinary, team-based care models intended to address complex pediatric needs where coordinated assessments and interventions are required in a single encounter. Nationally, T1024 matters because it documents specialized, bundled team services that may affect authorization pathways, care coordination payments, and access to multidisciplinary pediatric programs.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find an explanation of the clinical and service context for T1024, payer coverage considerations, common billing modifiers, and typical sites of service. The publication summarizes how T1024 is used to record integrated team encounters, provides benchmark guidance where available, and highlights policy and billing practice points relevant to hospitals, outpatient specialty clinics, and contracted community-based programs.
The content is intended for a national audience of billing professionals, compliance officers, and clinical program managers seeking concise, actionable information about the purpose and use of HCPCS Level II code T1024 in multidisciplinary pediatric care settings.
Billing Code Overview
HCPCS Level II code T1024 describes evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter. The service type is coordinated multidisciplinary evaluation and treatment focused on children with multiple or severe handicaps. The typical site of service is outpatient specialty clinics or contracted community-based programs where integrated teams (for example, pediatric rehabilitation, developmental pediatrics, or multidisciplinary specialty teams) provide coordinated care per encounter.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A child with multiple, severe developmental and physical disabilities is referred to a pediatric integrated specialty team for a coordinated care encounter billed with T1024. Typical patients include children with complex medical needs such as severe cerebral palsy with feeding difficulties, profound intellectual disability with seizure disorder, or multiple congenital anomalies requiring multidisciplinary input. The clinical workflow begins with a referral from primary care or a pediatric subspecialist. On the day of service the family meets with the integrated team — commonly including a pediatrician or developmental-behavioral pediatrician, a pediatric neurologist, a pediatric rehabilitation specialist, a dietitian, a social worker, and therapy staff (physical/occupational/speech) — either in a single combined visit or in a sequence of coordinated assessments documented as one encounter.
During the encounter the team performs a comprehensive evaluation of medical, functional, nutritional, and psychosocial needs; reviews current medications, therapies, and equipment; performs targeted physical examinations and assessments; and develops a coordinated plan of care with short- and long-term goals. Documentation includes the names and roles of team members participating, time and face-to-face interactions, assessment findings, the integrated plan of care, and follow-up arrangements. Typical site of service is an outpatient multidisciplinary clinic or specialty center, though services may also be delivered in other contracted settings where integrated pediatric specialty teams provide coordinated care to multiple or severely handicapped children. Encounters are billed per visit using T1024 when the integrated specialty team structure and coordinated care activities meet payer requirements for this HCPCS Level II code.
Coding Specifications
| Modifier |
|---|