T1028 HCPCS code: Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs
T1028 is the HCPCS Level II code for assessment of home, physical and family environment, to determine suitability to meet patient's medical needs. Its Medicare coverage code is I (Not payable by Medicare): Medicare does not pay separately under this code; another code applies.
Code details
| Field | Value |
|---|---|
| Section | T codes — National codes established for state Medicaid agencies |
| Coverage code | I — Not payable by Medicare |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | Z2 |
| Added | 2003-01-01 |
| Last action effective | 2003-01-01 |
What changed for T1028
- 2003-01-01: T1028 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code T1028?
T1028 is the HCPCS Level II code for assessment of home, physical and family environment, to determine suitability to meet patient's medical needs. Short descriptor: "Home environment assessment".
Does Medicare cover T1028?
Coverage code I — Not payable by Medicare. Medicare does not pay separately under this code; another code applies.
Related T10 codes
- T1000 — Private duty / independent nursing service(s) - licensed, up to 15 minutes
- T1001 — Nursing assessment / evaluation
- T1002 — Rn services, up to 15 minutes
- T1003 — Lpn/lvn services, up to 15 minutes
- T1004 — Services of a qualified nursing aide, up to 15 minutes
- T1005 — Respite care services, up to 15 minutes
- T1006 — Alcohol and/or substance abuse services, family/couple counseling
- T1007 — Alcohol and/or substance abuse services, treatment plan development and/or modification
- T1009 — Child sitting services for children of the individual receiving alcohol and/or substance abuse services
- T1010 — Meals for individuals receiving alcohol and/or substance abuse services (when meals not included in the program)
- T1012 — Alcohol and/or substance abuse services, skills development
- T1013 — Sign language or oral interpretive services, per 15 minutes
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Next steps
- Run a reimbursement report for a device billed under T1028
- Watch T1028 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for T1028
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.