What is HCPCS code T2025?
T2025 is the HCPCS code for waiver services not otherwise specified. What the CMS descriptor says, how states define it, real 2026 rates and billing tips.
T2025 is the HCPCS code for Medicaid waiver services that no other code describes. The CMS descriptor is just “waiver services; not otherwise specified.” It has no national unit, so the state decides what service it covers, the unit (15 minutes, hour, day, meal) and the rate. Medicare does not pay it.
What does the T2025 descriptor say?
The CMS long descriptor reads: “Waiver services; not otherwise specified (nos)” (CMS HCPCS quarterly update, October 2026 file). Its Medicare coverage code is “I,” not payable by Medicare.
| Field | Value |
|---|---|
| Unit | None nationally. Set by the state |
| Medicare | Not payable |
| Typical payers | Medicaid HCBS waivers |
| What it covers | Whatever the state assigns to it |
“Not otherwise specified” codes are a catch-all. When a waiver includes a service that has no HCPCS code of its own, the state can assign T2025 and define it in its fee schedule, often with modifiers to tell one T2025 service from another.
How do states use T2025?
Very differently. The same code can mean meals in one waiver and residential support in another.
| State and program | Code and modifiers | Service | Unit | Rate | Effective |
|---|---|---|---|---|---|
| Alaska | T2025 | Meals: congregate | Per meal | $32.26 | July 1, 2026 |
| Alaska | T2025 CG | Acuity add-on, 1 recipient to 1 direct care staff | Per 8 hours | $169.82 | July 1, 2026 |
| Alaska | T2025 TG | Acuity add-on, 1 recipient to 2 direct care staff | Per 8 hours | $339.63 | July 1, 2026 |
| South Dakota, CHOICES waiver | T2025 U1 | Supervised living, tier 1, home size 1 | Daily | $182.87 | June 1, 2026 schedule |
| South Dakota, CHOICES waiver | T2025 U6 US | Supervised living, tier 6, home size 6 | Daily | $308.39 | June 1, 2026 schedule |
Sources: Alaska Department of Health, Chart of Waiver Services Rates, and South Dakota’s CHOICES Waiver Fee Schedule (FY27 rates). Alaska’s chart lists base rates, which it adjusts by region (up to 1.5 times in the Aleutian Region).
South Dakota uses the first modifier (U1 to U6) for the support tier and the second (UN through US, then UA and UB) for how many people live in the home. A home of one has no second modifier. That’s a state convention. Nationally, UA and UB are “Medicaid level of care 10” and “11.” See home care billing modifiers.
When would a non-medical home care agency bill T2025?
Only when your state’s waiver tells you to. Personal care, homemaker, companion and respite usually have their own codes, such as T1019, S5130, S5135 and S5150. If a case manager authorizes T2025, ask which service it stands for, what the unit is and which modifiers are required.
What are the billing tips for T2025?
- Get the definition in writing. The authorization or fee schedule should name the service, unit and modifiers.
- Never assume a 15-minute unit. T2025 has no national unit. Alaska’s chart alone uses both per meal and per 8 hours.
- Expect more review. Catch-all codes can draw extra questions from payers, so keep the plan of care and visit records tied to each claim.
- Check modifier order. States that use two modifiers may require them in a set order.
Find your state’s waiver programs in the Medicaid waiver lookup.
FAQ
What does “NOS” mean in T2025? Not otherwise specified. It is for a waiver service that no more specific HCPCS code describes.
What unit is T2025 billed in? Whatever the state sets. Examples include per meal, per 8 hours and per day.
Can I use T2025 if I can’t find the right code? No. Use T2025 only when your state’s fee schedule or the authorization assigns it to the service you provide.
General information, not billing or legal advice. Check your state Medicaid agency’s current fee schedule and waiver rules.