2025 HCPCS code S9504
(Active) Effective Date: N/A Revision Date: N/A Home Infusion Therapy - Home Therapy Services S9490-S9810 Temporary National Codes (Non-Medicare) S0012-S9999 Feed
Home infusion therapy for antibiotic, antiviral, or antifungal drugs administered every 4 hours, including administrative, pharmacy, and care coordination services (drugs and nursing visits billed separately), per diem.
Medical necessity for S9504 must be supported by documentation demonstrating that the patient requires long-term, frequent (every 4 hours) administration of anti-infective medication, and that this therapy is safely and effectively administered in the home setting.
This service involves a qualified physician prescribing the medication, a closed-door pharmacy preparing it, and nursing staff administering or training the patient for self-administration.
In simple words: This code covers the behind-the-scenes services to provide medicine through a needle or tube at home for infections, every four hours. It includes the planning, pharmacy preparation, and coordination of care, along with any necessary supplies.The medicine itself and nurse visits are billed separately.
This code covers the administrative, professional pharmacy, and care coordination services associated with home infusion therapy for antibiotic, antiviral, or antifungal drugs administered every four hours.It includes all necessary supplies and equipment for the therapy.The drug itself and nursing visits for administration are billed separately.
Example 1: A patient with a severe bone infection requires long-term intravenous antibiotics every 4 hours, administered at home., A patient with a compromised immune system develops a viral infection requiring antiviral medication every 4 hours via a catheter at home., A patient with a persistent fungal infection receives antifungal medication every 4 hours via home infusion.
Documentation should include the physician's order for home infusion therapy, the type and frequency of medication, the pharmacy compounding record, the plan of care, and any instructions for self-administration or nurse visits.The diagnosis necessitating home infusion should also be clearly documented.
** This code is specific to the administrative, pharmacy, and coordination aspects of home infusion therapy.It does not include the cost of the drug, supplies, equipment, or nursing services, which must be coded separately. Be sure to confirm coverage and reimbursement policies with individual payers, as S-codes are not universally recognized.
- Payment Status: Active
- Specialties:Infectious Disease, Oncology, Home Health
- Place of Service:Home