Summary & Overview
HCPCS T2046: Hospice Long Term Care Room and Board, Per Diem
HCPCS Level II code T2046 denotes hospice long-term care room and board billed on a per diem basis. This code captures non-clinical hospice services that cover lodging and basic custodial support in long-term care facilities, separating room-and-board charges from clinical hospice interventions. Nationally, clear coding for room and board ensures accurate billing across payer types and supports consistent identification of hospice facility charges.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of where T2046 applies clinically, typical sites of service, and what payers commonly cover for hospice room and board. The publication also summarizes benchmarking considerations, common billing modifiers (where available), and any recent policy updates relevant to hospice per diem billing.
This analysis is intended for a national audience and provides operational context for coding teams, hospice administrators, and revenue cycle staff seeking concise guidance on the purpose and application of T2046. Data not available in the input will be identified as such in the appropriate sections.
Billing Code Overview
HCPCS Level II code T2046 describes hospice long term care, room and board only; per diem. The service type is hospice room and board provided on a per diem basis. The typical site of service is long-term care facility settings where hospice delivers room and board services separately from clinical hospice care.
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Clinical & Coding Specifications
Clinical Context
A typical patient is an elderly resident of a long-term care facility with a terminal illness electing hospice care for comfort-focused treatment. The hospice agency contracts with the long-term care facility to provide room and board only; clinical hospice services (nursing, social work, medical oversight, hospice supplies) are billed separately. The resident has daily oversight by facility staff with periodic hospice interdisciplinary team visits. Billing uses per diem hospice rates for room and board to cover lodging, utilities, basic nursing assistance provided by the facility, and facility overhead while the hospice remains responsible for hospice-certified services. Chart workflow includes hospice eligibility documentation (prognosis ≤ six months if illness runs its usual course), signed election statements by the patient or legal representative, admission orders, interdisciplinary plan of care, daily facility notes documenting room and board services, and periodic hospice visit notes. The facility submits the room-and-board per diem charge under T2046 with appropriate patient identifiers, hospice certification and election dates, and any applicable modifiers to indicate unusual circumstances or payment adjustments.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when facility care requires substantially greater resources or complexity beyond usual room-and-board due to extraordinary circumstances documented in facility notes. |