2025 HCPCS code S9338
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Home Healthcare - Home Infusion Therapy Temporary National Codes (Non-Medicare) Feed
Home infusion therapy for immunotherapy, including administration, pharmacy services, coordination, supplies, and equipment (excluding drugs and nursing visits), per diem.
Modifiers may apply depending on the circumstances of service. Refer to the appropriate modifier guidelines for proper use.
Medical necessity for code S9338 is established by the patient's diagnosis, the need for immunotherapy, and the clinical judgment that home infusion therapy is medically appropriate and safe for the patient.Factors considered include the patient's overall health status, ability to receive intravenous therapy at home, and availability of adequate support systems.
The clinical responsibility includes overseeing the entire home infusion process, from medication preparation and administration to patient monitoring and care coordination. This may involve physicians, nurses, pharmacists, and other healthcare professionals, depending on the complexity of the case and payer requirements.The provider is responsible for ensuring proper medication administration, managing adverse events, and coordinating with other healthcare professionals involved in the patient's care.
In simple words: This code covers the cost of giving immunotherapy medication at home through an IV. It includes things like setting up the IV, getting the medicine ready, and coordinating care, but not the medicine itself or separate nurse visits. The cost is for each day of treatment.
This HCPCS code, S9338, represents home infusion therapy specifically for immunotherapy.It encompasses administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment required for the infusion process.Importantly, the cost of the immunotherapy drugs themselves and separate nursing visits are not included in this code and must be billed separately. This code is billed on a per-diem (daily) basis.
Example 1: A patient with advanced melanoma is receiving intravenous immunotherapy at home.Code S9338 covers the daily costs associated with the home infusion setup, administration, pharmacy services, and care coordination., A patient diagnosed with multiple myeloma is undergoing home infusion therapy with an immunotherapy drug.Code S9338 would cover the daily costs of the infusion process, excluding the cost of the drug itself and any separate nursing visits which should be billed separately., A patient with relapsed lymphoma is receiving a combination immunotherapy treatment at home.Code S9338 would apply to the daily costs associated with administering the therapy via IV infusion at the patient's home.The individual drugs and nursing visits would be billed separately.
Detailed medical records should support the medical necessity for immunotherapy and home infusion. This includes the diagnosis, treatment plan, physician's orders, medication administration records, and documentation of all services provided under code S9338, including care coordination and any complications encountered.Documentation of patient education and assessment should also be included.
** This code is specific to home infusion of immunotherapy.It is a temporary code and its continued use may be subject to future revisions or replacement. Always refer to the latest HCPCS code set for updates.This code does not include the cost of the drugs themselves. These must be billed using appropriate codes.Separate codes should also be used for nursing visits.
- Global Days: Per diem billing; no global period applies.
- Payment Status: Active for non-Medicare payers
- Modifier TC rule: A technical component (TC) modifier is not applicable to this code.
- Specialties:Oncology, Hematology, Immunology
- Place of Service:Home