Update to EPSDT Home Health Services FAQs

September 26, 2019

The EPSDT Services: Home Health Services FAQs have been updated.

On January 1, 2019, the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) home health services code conversion became effective. Published billing instructions offered suggested HIPAA-compliant national code equivalents to the previously used HCPCS Level III local codes.

Providers are advised not to bill HCPCS Level II codes T1030 and T1031 (nursing care, in the home) per diem codes and to instead continue using local codes Z5805 (EPSDT shared nursing RN) and Z5807 (EPSDT shared nursing LVN) in order to receive the previous hourly rate.