HCPCS Code T1030: Nursing Care in the Home by Registered Nurse, Per Diem

T1030 code covers per diem nursing care by a registered nurse in the home, including assessment, medication, and patient education.

Use Code

## **What is the T1030 code?** HCPCS code T1030 indicates registered nurse (RN) care provided in the home on a per‑diem basis. This code is used primarily by state Medicaid agencies or managed care plans (not covered under Medicare Part B). It encompasses comprehensive nursing services delivered throughout a single day, including assessment, medication administration, wound care, patient education, and clinical decision-making. This personal care by a registered nurse is often utilized for patients who require continuous yet non-institutional support. RN home care per diem is structured for patients who require ongoing skilled nursing but not continuous supervision; it consolidates multiple interventions into one daily unit. The RN documents clinical findings, interventions, and care coordination activities, although CPT‑style evaluation and management codes are not used for billing. Services under this code include care in the home, covering the essential needs of patients across various care services. The code ensures that complex care episodes are captured as daily events without fragmenting services into minute-based units. When billed properly, T1030 facilitates smooth authorization and reimbursement workflows, ensuring eligible patients receive appropriate care.

## **T1030 documentation requirements** Documentation must reflect medical necessity for RN‑level clinical care delivered in the home. A plan of care or nursing care plan should specify the frequency and type of nursing services required. Nurse's visits should include date, scope of care, clinical assessment, interventions, patient response, and coordination with providers. Documentation often includes references to the patient’s life circumstances and healthcare needs, which determine eligibility for this code. Since T1030 is a per‑diem code, documentation must cover all care delivered on that day under the RN’s direction. Notes must be signed and dated. Supporting physician orders and care plan updates should be available. Even though not reimbursed by Medicare Part B, providers should maintain comprehensive records for audit and payer review. When reviewing billing codes, it's important to note the role of the registered nurse per diem in delivering both personal care and skilled interventions.

## **T1030 Billing requirements** T1030 is billed per day, regardless of total time spent by the RN. The RN’s NPI must appear on the claim, and it should be submitted under the facility or agency NPI if payer rules require. Modifier use depends on payer policy. As Medicare Part B does not reimburse T1030 (coverage indicator I), claims are typically submitted to Medicaid or state health plans. Providers should verify coverage with each insurer, as this code is not part of standard Medicare billing but recognized by certain state programs. In many systems, a table of authorized services may be referenced to determine whether a patient is eligible to receive services billed under T1030. Additionally, modifiers may be needed to indicate services performed in the home or by home health agencies. Authorization processes should include detailed documentation about the assessment and services provided.

## **Other relevant codes** - S9123 – Skilled home health aide services, per hour Often utilized for patients needing personal care or assistance with daily activities by a home health aide, which may be overseen by a registered nurse or licensed practical nurse. - T1031 – LPN home care, per diem This code represents home by licensed practical nurse (LPN) care services and is similarly structured to T1030. LPNs may perform delegated tasks under the supervision of an RN in a home care setting.

Frequently asked questions

The HCPCS code T1030 refers to nursing care in the home provided by a registered nurse per diem. While T1030 is recognized as a code for nursing care, it typically falls under Medicaid or other insurers rather than Medicare, which does not generally cover this code for home nursing per diem services.

The HCPCS code for services provided by a home health aide under a home health plan of care, typically billed in 15-minute increments, is G0156.

The HCPCS codes used for billing a TENS device are E0720 for a two-lead localized stimulation TENS device or E0730 for a four-lead localized stimulation device. These codes cover the device purchase or rental.