HCPCS Level II T2033: Residential Care, Waiver Per Diem

HCPCS Level II code T2033 describes a residential care, not otherwise specified (NOS), waiver service billed on a per diem basis, representing coverage for room-and-board–related supportive services provided in a residential care setting under a waiver program; the service type is residential waiver care and the typical site of service is a residential care facility or group home where beneficiaries receive daily custodial and supportive services.

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HCPCS Level II T2033: Residential Care, Waiver Per Diem

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Clinical & Coding Specifications

Clinical Context

Service: T2033 — Residential care, not otherwise specified (NOS), waiver; per diem

A typical patient is an adult beneficiary enrolled in a Medicaid waiver program who requires 24-hour supervised residential supports due to chronic medical, behavioral, or functional limitations that prevent safe independent living. Example scenario: a 68-year-old patient with advanced dementia, stage 3 pressure injury risk, and moderate functional dependence is approved for a home-and-community-based waiver. The payer authorizes per diem residential care under waiver rules to cover room, board, supervision, assistance with activities of daily living (ADLs), medication administration, and basic nursing oversight.

Clinical workflow: the interdisciplinary team (primary care clinician, geriatrician or internist, nurse case manager, social worker, and residential program staff) documents the medical necessity for residential placement in the care plan. The provider submits a per diem claim using T2033 with the appropriate diagnosis codes and applicable modifiers reflecting unusual circumstances (for example, increased complexity or a patient-directed transfer). Prior authorization and eligibility verification occur through the Medicaid waiver administrator prior to admission. Ongoing documentation includes daily progress notes, ADL/ILA (instrumental activities of daily living) assessments, medication administration records, and periodic clinical reassessments to support continued billing of the per diem service.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99304`	Nursing facility services, per day, for the evaluation and management of a patient, typically 30 minutes per day	Used when nursing facility E/M visits occur in conjunction with residential waiver per diem to document physician evaluation and management of a resident.
`99306`	Nursing facility services, per day, for the evaluation and management of a patient, typically 40 minutes per day	Higher complexity nursing facility E/M visit that may accompany the per diem when more time is required for assessment and coordination.
`99499`	Unlisted evaluation and management service	Used rarely for unique or non-standard E/M services related to waiver management not captured by existing codes; requires full documentation.
`92507`	Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual	Therapy services commonly provided to waiver residents with communication deficits; billed separately from the per diem.
`97535`	Self-care/home management training (eg, activities of daily living)	Therapy service for ADL training provided to residents as part of care plan; billed separately from `T2033`.
`99401`	Preventive medicine counseling, individual, approximately 15 minutes	Preventive counseling components provided by clinicians that may be billed separately if not included in the per diem under payer policy.

Related Modifiers

8 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…
54	Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…	- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
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…
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…
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.
363L00000X	Nurse Practitioner	(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
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…
207RI0001X	Clinical & Laboratory Immunology (Internal Medicine) Physician	An internal medicine physician who specializes in clinical and laboratory immunology disease management.
103TP0016X	Prescribing (Medical) Psychologist	A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive p…
163WP0808X	Psychiatric/Mental Health Registered Nurse	Nursing Service Providers · Registered Nurse

Related ICD-10-CM Codes

27 rows

ICD-10-CM Code	Description
E03.9	Hypothyroidism, unspecified
E11.9	Type 2 diabetes mellitus without complications
F01.50	Vascular dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F02.80	Dementia in other diseases classified elsewhere, 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
F07.0	Personality change due to known physiological condition
F32.9	Major depressive disorder, single episode, unspecified
F33.1	Major depressive disorder, recurrent, moderate
G30.9	Alzheimer's disease, unspecified
I10	Essential (primary) hypertension

Showing 1–10 of 27

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
Pneumatic Compression Devices (for Nebraska Only)	UnitedHealthcare	2026-08-01
Beds and Mattresses (for Kentucky 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
Enteral Nutrition (Oral and Tube Feeding) (for Pennsylvania Only)	UnitedHealthcare	2026-08-01
Pediatric Gait Trainers and Standing Systems (for Tennessee 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

Service: T2033 — Residential care, not otherwise specified (NOS), waiver; per diem

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99304`	Nursing facility services, per day, for the evaluation and management of a patient, typically 30 minutes per day	Used when nursing facility E/M visits occur in conjunction with residential waiver per diem to document physician evaluation and management of a resident.
`99306`	Nursing facility services, per day, for the evaluation and management of a patient, typically 40 minutes per day	Higher complexity nursing facility E/M visit that may accompany the per diem when more time is required for assessment and coordination.
`99499`	Unlisted evaluation and management service	Used rarely for unique or non-standard E/M services related to waiver management not captured by existing codes; requires full documentation.
`92507`	Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual	Therapy services commonly provided to waiver residents with communication deficits; billed separately from the per diem.
`97535`	Self-care/home management training (eg, activities of daily living)	Therapy service for ADL training provided to residents as part of care plan; billed separately from `T2033`.
`99401`	Preventive medicine counseling, individual, approximately 15 minutes	Preventive counseling components provided by clinicians that may be billed separately if not included in the per diem under payer policy.

Related Modifiers

8 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…
54	Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…	- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
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…
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…
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.
363L00000X	Nurse Practitioner	(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
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…
207RI0001X	Clinical & Laboratory Immunology (Internal Medicine) Physician	An internal medicine physician who specializes in clinical and laboratory immunology disease management.
103TP0016X	Prescribing (Medical) Psychologist	A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive p…
163WP0808X	Psychiatric/Mental Health Registered Nurse	Nursing Service Providers · Registered Nurse

Related ICD-10-CM Codes

27 rows

ICD-10-CM Code	Description
E03.9	Hypothyroidism, unspecified
E11.9	Type 2 diabetes mellitus without complications
F01.50	Vascular dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F02.80	Dementia in other diseases classified elsewhere, 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
F07.0	Personality change due to known physiological condition
F32.9	Major depressive disorder, single episode, unspecified
F33.1	Major depressive disorder, recurrent, moderate
G30.9	Alzheimer's disease, unspecified
I10	Essential (primary) hypertension

Showing 1–10 of 27

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
Pneumatic Compression Devices (for Nebraska Only)	UnitedHealthcare	2026-08-01
Beds and Mattresses (for Kentucky 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
Enteral Nutrition (Oral and Tube Feeding) (for Pennsylvania Only)	UnitedHealthcare	2026-08-01
Pediatric Gait Trainers and Standing Systems (for Tennessee 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 T2033: Residential Care, Waiver Per Diem

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OpenPayer

HCPCS Level II T2033: Residential Care, Waiver Per Diem

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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 T2033: Residential Care, Waiver Per Diem

Sign up for hcpcs T2033 policy alerts

HCPCS Level II T2033: Residential Care, Waiver Per Diem

Sign up for hcpcs T2033 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 service does HCPCS code T2033 represent?

When should modifier 22 or other modifiers be applied to T2033?

Which other CPT codes are commonly billed with or instead of T2033?

What diagnoses typically justify billing T2033?

Which specialties typically manage patients billed under T2033 and what administrative steps support billing?

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 service does HCPCS code T2033 represent?

When should modifier 22 or other modifiers be applied to T2033?

Which other CPT codes are commonly billed with or instead of T2033?

What diagnoses typically justify billing T2033?

Which specialties typically manage patients billed under T2033 and what administrative steps support billing?

References