Summary & Overview
HCPCS T2011: PASRR Level II Evaluation, Per Evaluation
HCPCS Level II code T2011 designates a PASRR Level II evaluation, a formal preadmission screening and resident review used when individuals are being considered for admission to long-term care facilities. This evaluation is intended to identify serious mental illness, intellectual disability, or other conditions that require specialized services, and to ensure appropriate placement and care planning. Nationally, PASRR Level II evaluations are a critical checkpoint in the long-term care admission pathway to protect patient safety and access to needed behavioral health supports.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical purpose, typical service setting, and the payer landscape that commonly reimburses for this evaluation. The publication covers benchmarks and utilization patterns, relevant policy or coverage updates affecting PASRR assessments, and the clinical context for when T2011 is used in the admissions process. Where input data is incomplete, the report notes that specific details are not available in the input. This summary is intended for national audiences involved in long-term care administration, case management, and billing operations.
Billing Code Overview
HCPCS Level II code T2011 represents a preadmission screening and resident review (PASRR) Level II evaluation, billed per evaluation. This service involves a formal assessment to determine whether individuals seeking admission to a long-term care facility require specialized mental health or intellectual disability services and whether the facility can meet those needs.
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Service type: PASRR Level II evaluation (comprehensive preadmission screening)
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Typical site of service: Long-term care facility admissions process, including skilled nursing facility (SNF) or nursing facility settings
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 72-year-old male resident of a nursing facility is referred for a Preadmission Screening and Resident Review (PASRR) Level II evaluation prior to transfer from an acute hospital to a long-term care nursing facility. The patient has a history of schizophrenia and stable chronic heart failure. The clinical workflow begins with a referral from the discharging hospital or the nursing facility admissions coordinator. A licensed clinician (often a psychologist, psychiatrist, psychiatric nurse practitioner, or licensed clinical social worker) completes a comprehensive Level II mental health and intellectual disability assessment including review of prior psychiatric history, medications, recent inpatient psychiatric records, cognitive screening, collateral interviews with family or caregivers, and behavioral observations. The evaluator documents functional limitations, potential risk factors, capacity for activities of daily living, and recommendations for specialized services or level-of-care determination. The completed Level II evaluation is submitted to the state mental health authority or designated PASRR entity and retained in the patient record. Typical documentation includes signed evaluation forms, informed consent where required, diagnostic impressions, and disposition recommendations (e.g., need for specialized psychiatric services, nursing facility admission with behavioral supports). Typical site of service is an inpatient hospital, nursing facility, or outpatient behavioral health clinic, billed per evaluation using T2011.
Coding Specifications
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