What is HCPCS code T1020?
T1020 is the per diem version of T1019, the Medicaid personal care code. The CMS descriptor, when a daily code applies, and how to bill it correctly.
T1020 is the HCPCS code for personal care services billed per diem, meaning one unit per day. It is the daily version of T1019, which is billed in 15-minute units. Only Medicaid programs that set a daily personal care rate use it. Medicare does not pay it.
What does the T1020 descriptor say?
The CMS long descriptor reads: “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)” (CMS HCPCS quarterly update, October 2026 file).
The wording is identical to T1019 except for the unit.
| Field | T1019 | T1020 |
|---|---|---|
| Unit | 15 minutes | Per diem (1 day) |
| Code added | July 1, 2002 | July 1, 2002 |
| Medicare coverage code | I (not payable by Medicare) | I (not payable by Medicare) |
| Excludes | Home health aide or CNA services | Home health aide or CNA services |
When is T1020 used instead of T1019?
Only when your state’s program pays personal care by the day. The state schedules we checked pay in-home personal care by the 15-minute unit. South Dakota’s Personal Care Agency Fee Schedule and Utah’s Waiver for Individuals 65 and Older rate sheet, both effective July 1, 2026, list T1019 and no T1020 line at all.
A daily code fits services priced by the day, where the state defines what a day of care must include. If your waiver or contract lists T1020, its service definition tells you:
- the minimum care or hours that count as a billable day
- whether partial days can be billed
- which modifiers are required
- how the day interacts with any hourly services the same client receives
Never bill T1020 just because a client had a long visit. If the authorization is in 15-minute units, bill T1019. Search your state’s programs in the Medicaid waiver lookup.
How should you bill T1020?
Bill 1 unit per calendar day of authorized service, and follow your state’s rules for what counts as a day.
- Match the authorization. The authorization should name T1020 and a number of days. If it names T1019 units, a daily claim will not match.
- Keep the daily documentation. A per diem rate still needs proof that care was provided that day, such as caregiver notes and EVV records.
- Check EVV. The 21st Century Cures Act EVV requirement covers Medicaid personal care. Some states handle live-in caregivers differently. See EVV and live-in caregivers.
- Don’t stack codes without checking. The state’s service definition decides whether T1019 units can be paid on the same day as a T1020 day.
For pricing private-pay daily care, see live-in care daily rates.
FAQ
Is T1020 the same as live-in care? Not by definition. The descriptor only says per diem. Your state’s service definition decides which arrangements qualify for a daily rate.
How many units do I bill for one day on T1020? One. The unit is a day, so a 7-day week is 7 units.
Does Medicare pay T1020? No. CMS lists it with coverage code I, not payable by Medicare.
General information, not billing or legal advice. Check your state Medicaid provider manual and fee schedule.