2025 HCPCS code S9490
Effective Date: N/A Home Therapy Services Feed
Home infusion therapy for corticosteroid infusion, including administrative, pharmacy, coordination, supplies, and equipment (excluding drugs and nursing visits), per day.
Medical necessity for home infusion therapy is determined by the patient's condition and the need for ongoing corticosteroid administration. The patient must be unable to receive the therapy in a clinical setting due to medical, mobility, or other logistical constraints. Documentation should clearly justify the home-based approach.
This code represents the services provided by a multidisciplinary team to facilitate home infusion therapy. A physician prescribes the medication, a specialized pharmacy prepares it, and nurses may administer the infusion or train the patient for self-administration. Care coordination ensures all aspects of therapy are managed appropriately.
In simple words: This code covers the daily costs of setting up and managing corticosteroid infusions at home. This includes administrative work, pharmacy services, coordinating care, and providing necessary supplies and equipment. It does not include the cost of the drugs or nursing visits, which are billed separately.
Home infusion therapy, corticosteroid infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem.
Example 1: A patient with rheumatoid arthritis requires daily intravenous corticosteroid infusions. Code S9490 is used to bill for the administrative, pharmacy, coordination, supplies, and equipment, while separate codes are used for the drug itself and any nursing visits., A patient with lupus experiences an exacerbation and needs a short course of high-dose corticosteroids at home. Code S9490 is used for each day of the therapy to cover the non-drug and non-nursing components., A patient with multiple sclerosis receives regular corticosteroid infusions to manage their symptoms. Code S9490 covers the daily support services associated with the home infusion.
Documentation should support the medical necessity of home infusion therapy and specify the corticosteroid being administered. Records from the prescribing physician, pharmacy, and any nursing staff involved should be maintained. Details of supplies and equipment provided should also be documented.
** Certain insurances and Medicaid use S codes for supplies and services. Medicare does not recognize S codes. Always verify coverage and reimbursement policies with the specific payer before billing.
- Specialties:Rheumatology, Immunology, Neurology, Gastroenterology
- Place of Service:Home