T1028 — Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs
T1028 is a HCPCS Level II code for assessment of home, physical and family environment, to determine suitability to meet patient's medical needs. It belongs to the National Codes for State Medicaid Agencies section. Medicare does not pay it — see the coverage note below before you bill it.
Medicare coverage: Not payable by Medicare
Medicare does not pay this code. It may still be valid for another payer, but a Medicare claim carrying it will not be reimbursed.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusI
Not valid for Medicare purposes. Medicare uses another code.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
The CMS record for T1028
- Long descriptor
- Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs
- Short descriptor
- Home environment assessment
- Added
- January 1, 2003
- BETOS
- Z2
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to T1028
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If T1028 is not quite right, the correct code is very often within a few positions of it.
- T1020Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant)
- T1021Home health aide or certified nurse assistant, per visit
- T1022Contracted home health agency services, all services provided under contract, per day
- T1023Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter
- T1024Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter
- T1025Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per diem
- T1026Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per hour
- T1027Family training and counseling for child development, per 15 minutes
- T1029Comprehensive environmental lead investigation, not including laboratory analysis, per dwelling
- T1030Nursing care, in the home, by registered nurse, per diem
- T1031Nursing care, in the home, by licensed practical nurse, per diem
- T1032Services performed by a doula birth worker, per 15 minutes
- T1033Services performed by a doula birth worker, per diem
- T1040Medicaid certified community behavioral health clinic services, per diem
- T1041Medicaid certified community behavioral health clinic services, per month
- T1502Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit
Questions about T1028
What is HCPCS code T1028?
T1028 is a HCPCS Level II code for assessment of home, physical and family environment, to determine suitability to meet patient's medical needs. It sits in the National Codes for State Medicaid Agencies section.
Does Medicare cover T1028?
The CMS HCPCS file marks T1028 as "Not payable by Medicare". Medicare does not pay this code. It may still be valid for another payer, but a Medicare claim carrying it will not be reimbursed.
How is T1028 paid under the physician fee schedule?
T1028 carries PFS status code I. Not valid for Medicare purposes. Medicare uses another code.