The T1019 HCPCS Code (often referred to as T1019 CPT Code or Procedure Code T1019) is used to bill for personal care services delivered in a home setting. These are non-skilled services designed to help patients with daily living activities such as bathing, grooming, dressing, and feeding.
In 2025, HCPCS T1019 continues to be one of the most frequently billed home health codes, especially under Medicaid and state-based waiver programs. It ensures accurate reimbursement for providers while giving elderly, disabled, or post-acute patients the essential support they need.
HCPCS Code T1019 covers non-skilled personal care provided by trained caregivers. Unlike skilled nursing or therapy services, T1019 focuses on supportive care that improves quality of life.
Covered Services Under T1019:
Important: T1019 cannot be billed for inpatients in hospitals, nursing facilities, or institutional settings.
Before services billed under T1019 can be reimbursed, specific requirements must be met. These include:
Compliance with these requirements is critical for ensuring accurate and timely reimbursement
Modifiers add clarity to billing. Below are the most frequently used CPT T1019 medical services rendered. For T1019, these include:
Billing Tip (2025): Always document caregiver ratios and service adjustments to justify modifier use.
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Understanding related HCPCS and CPT codes helps avoid billing confusion.
Although these codes may overlap, Code T1019 is specific to in-home personal care services.
Yes, Medicare and Medicaid often cover T1019 when:
However, coverage varies by state and payer. Always verify with the insurance provider before billing.
Authoritative Source: CMS HCPCS Quarterly Updates
Incorrect use of T1019 CPT Code or modifiers can cause:
By using HCPCS T1019 correctly, providers ensure timely reimbursement and patients get uninterrupted personal care services.
The T1019 HCPCS Code is vital for billing personal care services in home settings. In 2025, understanding its requirements, modifiers, and payer rules is key to avoiding denials and maximizing reimbursement.
Cures Medical Billing helps healthcare providers stay compliant with T1019 billing and reduce claim errors. If your practice struggles with denials or compliance, our team offers a free billing audit to improve your revenue cycle.
For more information on related topics or coding updates, explore other billing resources to stay compliant with Medicare and insurance guidelines.
CPT Code T1019 is used for billing personal care services at home, covering help with bathing, dressing, feeding, and mobility.
Yes. Most payers cover it when medical necessity and authorization requirements are met.
T1019 is billed in 15-minute units, so 4 units = 1 hour of care. Coverage depends on the state program and the individual’s care assessment.
For example, my uncle was approved for 4 hours/day, 5 days a week, which equals 80 T1019 units per week. Each person’s case is reviewed for medical necessity and safety in their home environment.
Not at all. It includes:
When I was a caregiver for my neighbor through a state-funded program, T1019 also included things like helping her get to the bathroom at night or reheating dinner small things that meant everything to her dignity.
T1019 is a Medicaid-specific code. Medicare typically does not cover non-medical personal care unless it’s part of a short-term home health episode after hospitalization.
If you or a loved one is on Medicaid or has a waiver, T1019 may be covered. Every state has slightly different rules, so it’s worth checking with your caseworker or managed care plan.
T1019 applies to home settings, while T1020 applies to long-term care facilities.
When I worked for a small home care agency, accurate T1019 documentation meant we could keep services going for our clients. We trained aides to log tasks clearly—because billing integrity meant continued care.
Yes, modifiers like T1019-U6, T1019-TT, and T1019-HQ specify caregiver ratios or temporary service increases.
Reimbursement rates vary by state and payer, but on average, they range between $15–$30 per hour. Always confirm with payer fee schedules.
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