HCPCS Code T2046: Hospice Long Term Care, Room and Board Only; per diem

Learn about HCPCS code T2046 for hospice long term care room and board per diem including documentation and billing guidelines.

Use Code

## **What is the HCPCS code T2046?** The HCPCS Code T2046 is defined as "Hospice long term care, room and board only; per diem." It is used specifically for billing hospice room and board services for patients receiving hospice care in a long term care facility, covering non-medical daily costs such as housing and meals, while also supporting palliative care, emotional support, and pain management to improve the patient's condition and quality of life. This code applies when hospice services are provided to patients residing in long-term care or specialty care nursing facility settings, and payments for T2046 claims are often calculated as a percentage of the custodial per diem rate for those facilities. The code represents a lower complexity level of hospice care focused primarily on the care room and board aspect rather than direct medical treatment or inpatient hospital care, emphasizing providing comfort to patients and families.

## **T2046 documentation requirements** The documentation requirements for HCPCS codes like T2046 include the following key points: - Claims for T2046 hospice room and board must be billed using the appropriate claim form with complete and accurate data fields to support reimbursement and services provided. - The name and national provider identifier (NPI) of the long-term care or nursing facility where services were delivered must be included on the claim (e.g., Box 32 and 32a in CMS 1500 forms). - If the patient has cost or patient liability, this must be documented in the appropriate claim field and aligned with the current Medicaid patient liability reports. - Hospices submitting room and board claims must use the most current claim forms and comply with format requirements like HIPAA 5010 electronic submissions. - Pass-through hospice room and board claims must be associated with revenue code 0658 along with T2046.

## **T2046 billing requirements** The billing requirements for HCPCS code T2046 are as follows: - The claim should be submitted as a single line item with the date of service span and units billed matching exactly. - Place of service code 34 (Hospice) must be reported in the claim field to indicate the hospice setting. - Proper documentation justifying the hospice care level and appropriateness of room and board billing under T2046 should be maintained for compliance and claims support. Failure to meet these billing requirements can cause denials or require corrected claims submission. This billing is specific to hospice services provided in long-term care or nursing facility settings, distinct from inpatient or home hospice billing codes.

## **Other relevant codes** - **T2043**: Hospice continuous home care; per hour - **T2044**: Hospice inpatient respite care; per diem - **T2045**: Hospice general inpatient care; per diem - **T2047**: Habilitation, prevocational, waiver; per 15 minutes