T2031 Assist living waiver/diem
Also known as: Assisted living, AL services
Assisted living waiver services, billed per diem. Daily per diem support services in assisted living residential settings for individuals needing functional assistance.
In Plain Language
Daily assisted living support; Residential assistance services
Clinical Context
Waiver-funded daily assisted living services providing personalized residential support for individuals who require assistance with activities of daily living while maintaining community residence.
RVU Information
CPT T2031 does not have a physician work RVU assigned by CMS. Reimbursement for this code is determined by payer-specific fee schedules.
Billing & Documentation
This HCPCS code requires documentation of medical necessity and a valid physician order. Coverage and reimbursement policies vary by payer. Check with the specific insurer for prior authorization requirements.
Specialties
Frequently Asked Questions
What is CPT code T2031?
CPT T2031 (Assist living waiver/diem) is a Other HCPCS code. Assisted living waiver services, billed per diem. Daily per diem support services in assisted living residential settings for individuals needing functional assistance.
Does Medicare cover T2031?
Medicare coverage for T2031 depends on medical necessity and applicable Local Coverage Determinations (LCDs). Waiver-funded daily assisted living services providing personalized residential support for individuals who require assistance with activities of daily living while maintaining community residence. A physician order is typically required.
When is CPT T2031 used?
Waiver-funded daily assisted living services providing personalized residential support for individuals who require assistance with activities of daily living while maintaining community residence.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.