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See a sample rate comparisonHCPCS T2048 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem
| Key Fact | Detail |
|---|---|
| Service Type | National Codes Established for State Medicaid Agencies Long-term Residential Care |
| Common Place of Service | None 99 - Other POS |
| Complexity Level | Low |
| ASAM Level | Level 3.1 - Clinically Managed Low-Intensity Residential |
| Care Type | Treatment |
| Setting | Residential |
National average reimbursement for HCPCS T2048 by major payers:
$76.56
$95.21
$239.41
$387.18
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HCPCS T2048
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See a sample payer proposalHCPCS T2048 vs. Other Long-term Residential Care Codes
The HCPCS T2048 code is part of the National Codes Established for State Medicaid Agencies services used for Long-term Residential Care. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS T2048 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| T2047-HCPCS | Low | Habilitation, prevocational, waiver; per 15 minutes |
| T2048-HCPCS | Low | Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem |
| T2049-HCPCS | Low | Non-emergency transportation; stretcher van, mileage; per mile |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS T2048. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the T2048 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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