Question 1

What is HCPCS code T1020?

Accepted Answer

HCPCS code T1020 is "Personal care ser per diem". Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant)

Question 2

What category is T1020 in?

Accepted Answer

T1020 belongs to HCPCS Category T (State Medicaid Agency Codes).

Question 3

When should I use HCPCS code T1020?

Accepted Answer

Use T1020 when billing for personal care ser per diem. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is T1020 covered by Medicare?

Accepted Answer

Coverage for T1020 (Personal care ser per diem) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for T1020?

Accepted Answer

Documentation for T1020 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).