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2025 HCPCS code T2033

Residential care services, not otherwise specified, provided on a per diem basis as part of a Medicaid waiver program.

HCPCS codes starting with "T" are used by Medicaid and are not payable by Medicare. These codes are used to track services provided under state-specific waivers.

Medical necessity must be established for the residential care services to be covered under the waiver. This includes documentation demonstrating the patient's need for supervision, assistance with daily living activities, and other care provided in the residential setting.

Residential care is typically provided by caregivers and other staff in a residential care facility or similar setting.

In simple words: This code covers daily room and board and personal care services, like help with bathing and dressing, given in a home-like setting to people who need support. This is part of a special program where Medicaid pays for services that are not normally covered.

This code covers daily residential care services not otherwise specified by another HCPCS code, provided under a Medicaid waiver program.A waiver allows Medicaid to cover specific services and equipment outside the standard state plan. Residential care offers long-term care in a home-like setting for individuals needing supervision, including medical assistance and help with daily living activities.

Example 1: A patient recovering from surgery needs temporary housing and assistance with daily living activities but does not require skilled nursing care. They stay in a residential care setting, and T2033 is billed for each day of service., An individual with a developmental disability needs long-term supervision and support with daily activities.A residential care facility provides the services, and T2033 is billed for each day., A patient with a chronic condition requiring ongoing monitoring but not hospitalization receives daily assistance in a residential care setting.T2033 is billed for each day of residential care service.

Documentation must support the medical necessity for residential care services and indicate the specific services provided.Daily notes should detail the level of assistance needed and any medical care received.

** This code is for non-skilled residential care. If skilled nursing or other medical services are provided, they should be billed separately with the appropriate codes. As this code is used under Medicaid waivers, coverage and billing policies can vary by state.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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