T1031 HCPCS Code: Nursing care (Units, EVV, Rates, Denials)

T1031 is “Nursing care, in the home, by licensed practical nurse, per diem.” It is billed per day and covers a day of LPN care in the home, used by programs that pay nursing by the day rather than by the hour. Medicare does not pay it. EVV is required for Medicaid home health services, and some states also require it for private duty nursing; check your state.

Units and rounding

One unit is one day. The state’s service definition sets what counts as a billable day of nursing, such as a minimum number of hours. Don’t bill an hourly or 15-minute code for the same service on the same day unless the program allows it.

Modifiers you will see

• U1–U9: State-defined; often distinguish programs (waiver vs state plan), service levels or provider types
• TE: Service delivered by an LPN/LVN

Modifier meanings are set by each state and payer, so check your provider manual. See home care billing modifiers.

Typical rates

Daily nursing rates are set per state program and managed-care plan. Each state program and managed-care plan sets its own rate, so use your state’s current fee schedule.

Common denial reasons

• Days exceed the authorization
• No current physician order or plan of care
• Daily and hourly nursing billed for the same date
• Service date outside the authorization period

Related codes

• T1030: Nursing care, in the home, by registered nurse, per diem
• S9124: Nursing care, in the home; by licensed practical nurse, per hour
• G0300: Direct skilled nursing services of a licensed practical nurse (LPN) in the home health or hospice setting, each 15 minutes

Source

CMS HCPCS Level II code set (quarterly update). Confirm the exact descriptor and any state-specific unit definition in your payer’s billing manual. Last reviewed November 6, 2026.

General information, not billing or legal advice. Check your state Medicaid agency’s current fee schedule and provider manual.