HCPCS code T2022 – Monthly case management

Key takeaways

HCPCS code T2022 is the state Medicaid code for case management, per month, and Medicare does not pay it.

One unit covers one calendar month, so the month bills once however many contacts the case manager logs.

States set the contact standard that earns the unit, such as Indiana’s monthly case note and a face-to-face visit every 90 days.

T2023 bills targeted case management per month, while T1016 and T1017 bill case management in 15-minute units.

In Pabau, the practice software we build, case notes, appointments and claims share one patient record, so each billed month traces back to its contacts.

What is HCPCS code T2022?

HCPCS code T2022 is a Level II code that state Medicaid programs use to pay for case management, billed per month. Its official CMS descriptor is: Case management, per month. One unit covers a calendar month of coordinating a member’s care, not a single visit or call.

Under CMS’s HCPCS Level II coding system, T2022 sits in the T1000-T5999 range of national codes established for state Medicaid agencies. These T-codes are not payable by Medicare and do not appear on the Medicare Physician Fee Schedule. Each state decides whether it covers T2022, which program uses it, and what it pays.

Case management under T2022 means assessing what a member needs, arranging services, and checking that those services arrive. It is common in home and community-based services (HCBS) waivers under section 1915(c) of the Social Security Act. Those waivers fund community care for people who would otherwise need institutional care.

T2022 code description and details

The table below summarizes the administrative attributes of HCPCS code T2022 as published in the CMS HCPCS Level II code set.

Check the current-year status of T2022 and its neighbors in the CMS quarterly HCPCS file before each new plan year.

What T2022 covers and what it does not

T2022 pays for the coordination around a member’s services, not the services themselves. The monthly rate covers the case manager’s work across the month, whatever mix of visits, calls and meetings that took.

The services a case manager arranges carry their own codes. Assisted living arranged through a waiver, for example, bills per diem under HCPCS code T2031. Financial management for a member who self-directs has its own line as well, under code T2040.

A child’s community-based wrap-around program is another such service. Its child and family team coordination is paid in that program’s per diem under H2022, not as a separate monthly T2022 unit.

Covered under T2022:

• Assessing the member’s needs and reviewing them when their condition changes
• Referring the member to providers and arranging the services in their plan
• Monitoring that services are delivered as planned, through face-to-face and phone contacts
• Coordinating with family, guardians and providers when the member’s needs change
• Keeping the service plan current with the member’s team

Not covered under T2022:

• The direct services the case manager arranges, such as personal care, day habilitation or assisted living
• Initial service assessment or plan of care development, where the state bills it under T2024
• Case management time already billed in 15-minute units under T1016 or T1017
• Case management by an agency that also provides other HCBS to the same member, unless the state holds a CMS-approved exception

The last exclusion catches agencies that grow into case management. Under 42 CFR 441.301(c)(1)(vi), a provider of HCBS for a member cannot also provide that member’s case management. The exception applies only where the state shows no other willing and qualified entity serves the area.

T2022 vs T2023 and adjacent case management codes

T2022 and T2023 both bill case management by the month. T2023 is targeted case management, a state plan benefit for a population the state defines under section 1915(g) of the Social Security Act. T2022 is the general code, which states such as Indiana use for waiver case management.

The 15-minute codes split the same work by time. T1016 bills case management in 15-minute units, and HCPCS code T1017 bills targeted case management the same way. HCPCS code T2024 covers service assessment and plan of care development under a waiver, which some states pay separately.

Two questions place a service in the right code. Is it targeted case management, and does your state pay it by the month or by the quarter hour?

Pick the code your state’s fee schedule lists for the program, not the one whose wording fits best. A state that publishes T1017 for its targeted case management can deny T2023 for the same service.

Which Medicaid programs use T2022?

States use T2022 wherever they pay case management, or a related coordination service, as a flat monthly fee. Indiana’s DDARS HCBS waiver provider module, published September 24, 2026, shows how one state does it:

• Family Supports and Community Integration and Habilitation (CIH) waivers: Case management bills as T2022 U7 U5 at $189.56 per month. The cap is one unit a month.
• Health and Wellness and traumatic brain injury (TBI) waivers: Care management bills as T2022 U7 at $189.56 a month.
• CIH waiver wellness coordination: Three tiers share T2022, separated by modifiers U1, U2 and U3, at $118.66, $163.02 and $251.74 a month.
• Health and Wellness and TBI integrated health care coordination: T2022 U7 U1 bills in 15-minute units at $14.21, up to 16 hours a month.

The last row shows why the national descriptor is only a starting point. Indiana bills one T2022 service in quarter hours, despite the per-month wording. The state fee schedule sets the unit and the modifiers, so read both columns before you count units.

How to bill T2022: Units, place of service, and modifiers

Accurate T2022 billing depends on the unit, the service dates, the place of service and any state modifiers. Each field is checked on its own, so one error can deny a month that was fully worked.

A second unit for the same member and month usually reads as a duplicate. Months that start or end mid-enrollment follow state rules, so check those rules before billing a partial month.

HCPCS modifiers U1 through UD are reserved for each state Medicaid program to define. The same modifier can mean different things in two states, so never copy modifiers from another state’s guidance.

Prior authorization requirements for T2022

Most states require case management to appear in an approved service plan or authorization before the first month is billed. Some waivers authorize it inside the plan itself, while others issue a separate approval.

The authorization for a T2022 month typically rests on three layers:

1. Eligibility and enrollment: The member is Medicaid-eligible and enrolled in the program that pays T2022 for every day of the billed month.
2. Service plan: The person-centered service plan names case management, the agency providing it, and the authorized period.
3. Provider choice: The member chose the case management agency, and that agency holds no conflicting HCBS role for them.

Running insurance eligibility verification at the start of each month catches a lapsed waiver enrollment before a full month of work goes unpaid.

Documentation requirements for T2022 claims

Because the unit is a month, an auditor asks one question about each claim. What happened with this member in this month? A month with no qualifying contact on file cannot support a unit, however much work went on around it.

Indiana’s standard shows what a state can require. Case managers there enter a case note for each encounter, at least one per month. They also meet the member face to face at least every 90 days.

Required documentation typically includes:

• Monthly case notes: Dated notes for each contact, showing what was reviewed and what happens next
• Face-to-face contact record: Dates and locations of in-person visits, at the frequency the state requires
• Current service plan: A signed plan in date for the billed month that names case management as an authorized service
• Monitoring checklist: The state’s form for reviewing health, safety and service delivery, where one is required
• Enrollment proof: Confirmation the member was enrolled in the program on the service dates
• Choice of provider record: Evidence the member selected the case management agency

Keep these records exportable by member and month, because that is how an auditor will request them. Medical billing compliance controls make that request a report rather than a search.

Compatible ICD-10 diagnosis codes for T2022

T2022 claims still carry an ICD-10-CM diagnosis, usually the condition that qualifies the member for the program. Case management is not tied to one diagnosis, so the code follows the waiver population.

Cross-check each pairing against the full ICD-10-CM codes index and your state’s program criteria. The diagnosis on the claim should match the one in the member’s eligibility assessment.

T2022 reimbursement rates and fee schedule 2026

T2022 has no national rate, because Medicare does not price T-codes. Each state Medicaid program or managed care organization sets its own monthly rate. Indiana’s current waiver module, for example, pays $189.56 a month for waiver case management.

To find the current T2022 rate for your state:

1. Open your state Medicaid agency’s waiver fee schedule or provider reference module.
2. Search for T2022, then match the row by program and modifier.
3. Note the effective date, because states revise waiver rates.
4. Check whether a managed care organization administers the program, since its contracted rate can differ.

Check each remittance advice against the published rate. A monthly code underpaid by a few dollars repeats for every member, every month.

Common reasons T2022 claims are denied

T2022 denials cluster around the monthly unit. Most trace back to a month with no qualifying contact, a duplicate unit, a lapsed enrollment, or the wrong payer.

Sorting T2022 denials by root cause shows which workflow fix pays first. When the same reason repeats across a billing cycle, the process is producing it. A structured denial management workflow turns that pattern into a fix.

How Pabau supports monthly T2022 case management billing

Many case management agencies track monthly contacts in one place and bill in another. The case note sits in a spreadsheet or paper file, and the claim is built from memory at month-end.

Pabau keeps case notes, appointments and claims on the same patient record. Its claims management software builds the T2022 claim from that record, so you can check each billed month against the contacts behind it.

Scheduling covers the other end of the month. Booking each member’s monthly contact and any required face-to-face visit in Pabau’s calendar shows who is still due before the month closes.

Bill every case management month with its notes attached

Pabau keeps case notes, appointments and claims on one patient record. Each T2022 month traces back to a documented contact before the claim leaves your agency.

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Conclusion

HCPCS code T2022 looks simple, one unit for one month of case management. The work sits in proving that the month happened, under your state’s contact standard, for an enrolled member, on an authorized plan.

Treat the state fee schedule as the source of truth for the unit and the modifiers. Then close each month only when its case note is signed. Billing in that order turns most T2022 denials into scheduling problems you can see coming.

Book a demo to see how Pabau ties monthly case notes to T2022 claims for Medicaid case management teams.

Continue your research

Need to understand how clean claims reduce denial rates? Submitting clean claims walks through the components of a complete claim and what payers check at adjudication.

Decoding a T2022 remittance? Denial codes in medical billing maps CARC and RARC codes to the fix each one needs.

Want to understand the billing cycle end to end? Revenue cycle management explains how claims move from service delivery to payment posting.

Building the claim from the encounter record? What a superbill includes lists the fields a payer expects before it will adjudicate a claim.

New to Medicaid billing? What is medical billing covers how codes, claims and payers fit together.

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