HCPCS T2022: Case Management, Per Month

HCPCS Level II code T2022 represents case management, billed per month, documenting ongoing coordination of care activities for patients with complex needs; the service type is case management and the typical site of service is outpatient or community-based care where monthly administrative and clinical coordination is provided.

For related coverage guidance, see recent payer policy updates: Interferential Stimulation Devices (for home use), Prior Authorization for Durable Medical Equipment (DME), Breast Pumps.

Customize your policy alerts

Sign up for hcpcs T2022 policy alerts

Get alerted when payer policies referencing T2022 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Clinical & Coding Specifications

Clinical Context

A typical patient for T2022 is an adult with multiple chronic conditions such as congestive heart failure, diabetes mellitus with complications, or chronic obstructive pulmonary disease who requires monthly interdisciplinary coordination to manage medications, follow-up appointments, durable medical equipment, home health services, and social supports. The patient is enrolled in a case management program run by a primary care practice, community health center, or managed care organization.

The clinical workflow begins when a primary care clinician or hospital discharge planner identifies the patient as high risk for readmission or poor disease control. The case manager (often a registered nurse or social worker) performs an initial assessment, documents a care plan, communicates with specialists, coordinates referrals (home health, durable medical equipment, behavioral health), arranges medication reconciliation, and schedules follow-up visits. Monthly activities billed under T2022 typically include telephone outreach, home or clinic visits, coordination with pharmacy and community resources, documentation of progress toward care plan goals, and adjustment of services as needed. Documentation must support monthly case management activity, time spent, interventions provided, and measurable care plan updates.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99487`	Complex chronic care management services, first 60 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month	May be performed alongside `T2022` when clinical teams bill CPT-based complex chronic care management for time-based clinical staff activities; `T2022` documents the HCPCS-level case management per month.
`99489`	Each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month	Billed with `99487` when additional time is required; complements monthly case management activities documented under `T2022`.
`99490`	Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month	Lower-intensity monthly care management frequently provided to patients eligible for `T2022`; may be billed by practices using CPT rather than HCPCS when payer rules allow.
`99354`	Prolonged physician services with direct patient contact, first hour (list separately in addition to office or other E/M service)	Used when a clinician provides unusually prolonged direct service related to case management activities; may be billed in conjunction with E/M services occurring in the same month as `T2022`.
`99495`	Transitional care management services with moderate medical decision complexity (within 14 days of discharge)	Frequently occurs before monthly `T2022` enrollment when a patient requires transition from inpatient to community care and subsequent monthly case management.
`99496`	Transitional care management services with high medical decision complexity (within 7 days of discharge)	Used for higher complexity transitions that often precede ongoing monthly case management billed as `T2022`.

Related Modifiers

7 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…
56	Modifier ‑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…
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
163W00000X	Registered Nurse	(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive…
251B00000X	Case Management Agency	An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access…
207R00000X	Internal Medicine Physician	A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
225XM0800X	Mental Health Occupational Therapist	Occupational therapists provide treatment for people recovering from a mental or physical illness to regain their independence and stability and to en…
207YX0901X	Otology & Neurotology Physician	An otolaryngologist who treats diseases of the ear and temporal bone, including disorders of hearing and balance. The additional training in otology a…
374K00000X	Religious Nonmedical Practitioner	A religious nonmedical practitioner offers spiritually-based care. Services may be rendered in an office, home, or care facility or by phone, email, …
103K00000X	Behavior Analyst	A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential …

Related ICD-10-CM Codes

25 rows

ICD-10-CM Code	Description
E11.9	Type 2 diabetes mellitus without complications
F19.20	Other psychoactive substance dependence, uncomplicated
F32.9	Major depressive disorder, single episode, unspecified
F33.9	Major depressive disorder, recurrent, unspecified
F41.9	Anxiety disorder, unspecified
G30.9	Alzheimer's disease, unspecified
I10	Essential (primary) hypertension
I50.9	Heart failure, unspecified
J45.909	Unspecified asthma, uncomplicated
N18.9	Chronic kidney disease, unspecified

Showing 1–10 of 25

Related Payer Policy Updates

Specialty: Durable Medical Equipment (DME)1 / 2

10 rows

Policy	Payer	Effective Date
Interferential Stimulation Devices (for home use)	Moda Health	2026-10-01
Prior Authorization for Durable Medical Equipment (DME)	Blue Cross Blue Shield - Rhode Island	2026-10-01
Breast Pumps	Moda Health	2026-09-01
Personal Emergency Response Systems	CareSource Georgia	2026-09-01
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

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.

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.

Explore openpayer tools

View all tools

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99487`	Complex chronic care management services, first 60 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month	May be performed alongside `T2022` when clinical teams bill CPT-based complex chronic care management for time-based clinical staff activities; `T2022` documents the HCPCS-level case management per month.
`99489`	Each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month	Billed with `99487` when additional time is required; complements monthly case management activities documented under `T2022`.
`99490`	Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month	Lower-intensity monthly care management frequently provided to patients eligible for `T2022`; may be billed by practices using CPT rather than HCPCS when payer rules allow.
`99354`	Prolonged physician services with direct patient contact, first hour (list separately in addition to office or other E/M service)	Used when a clinician provides unusually prolonged direct service related to case management activities; may be billed in conjunction with E/M services occurring in the same month as `T2022`.
`99495`	Transitional care management services with moderate medical decision complexity (within 14 days of discharge)	Frequently occurs before monthly `T2022` enrollment when a patient requires transition from inpatient to community care and subsequent monthly case management.
`99496`	Transitional care management services with high medical decision complexity (within 7 days of discharge)	Used for higher complexity transitions that often precede ongoing monthly case management billed as `T2022`.

Related Modifiers

7 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…
56	Modifier ‑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…
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
163W00000X	Registered Nurse	(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive…
251B00000X	Case Management Agency	An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access…
207R00000X	Internal Medicine Physician	A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
225XM0800X	Mental Health Occupational Therapist	Occupational therapists provide treatment for people recovering from a mental or physical illness to regain their independence and stability and to en…
207YX0901X	Otology & Neurotology Physician	An otolaryngologist who treats diseases of the ear and temporal bone, including disorders of hearing and balance. The additional training in otology a…
374K00000X	Religious Nonmedical Practitioner	A religious nonmedical practitioner offers spiritually-based care. Services may be rendered in an office, home, or care facility or by phone, email, …
103K00000X	Behavior Analyst	A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential …

Related ICD-10-CM Codes

25 rows

ICD-10-CM Code	Description
E11.9	Type 2 diabetes mellitus without complications
F19.20	Other psychoactive substance dependence, uncomplicated
F32.9	Major depressive disorder, single episode, unspecified
F33.9	Major depressive disorder, recurrent, unspecified
F41.9	Anxiety disorder, unspecified
G30.9	Alzheimer's disease, unspecified
I10	Essential (primary) hypertension
I50.9	Heart failure, unspecified
J45.909	Unspecified asthma, uncomplicated
N18.9	Chronic kidney disease, unspecified

Showing 1–10 of 25

Related Payer Policy Updates

Specialty: Durable Medical Equipment (DME)1 / 2

10 rows

Policy	Payer	Effective Date
Interferential Stimulation Devices (for home use)	Moda Health	2026-10-01
Prior Authorization for Durable Medical Equipment (DME)	Blue Cross Blue Shield - Rhode Island	2026-10-01
Breast Pumps	Moda Health	2026-09-01
Personal Emergency Response Systems	CareSource Georgia	2026-09-01
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

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.

HCPCS T2022: Case Management, Per Month

Sign up for hcpcs T2022 policy alerts

HCPCS T2022: Case Management, Per Month

Sign up for hcpcs T2022 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 T2022: Case Management, Per Month

Sign up for hcpcs T2022 policy alerts

HCPCS T2022: Case Management, Per Month

Sign up for hcpcs T2022 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 T2022 represent and where is it typically used?

Which provider types commonly deliver services billed with T2022 and what does the clinical workflow look like?

Which modifiers apply to T2022 and when should they be used?

Can T2022 be billed with related CPT codes like 99487, 99490, or transitional care management codes?

What patient diagnoses or clinical scenarios are commonly associated with T2022 and what documentation is expected?

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 T2022 represent and where is it typically used?

Which provider types commonly deliver services billed with T2022 and what does the clinical workflow look like?

Which modifiers apply to T2022 and when should they be used?

Can T2022 be billed with related CPT codes like 99487, 99490, or transitional care management codes?

What patient diagnoses or clinical scenarios are commonly associated with T2022 and what documentation is expected?

References