S0273 HCPCS code: Physician visit at member's home, outside of a capitation arrangement
S0273 is the HCPCS Level II code for physician visit at member's home, outside of a capitation arrangement. Its Medicare coverage code is I (Not payable by Medicare): Medicare does not pay separately under this code; another code applies.
Code details
| Field | Value |
|---|---|
| Section | S codes — Temporary national codes (non-Medicare) |
| Coverage code | I — Not payable by Medicare |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | Z2 |
| Added | 2007-04-01 |
| Last action effective | 2007-04-01 |
What changed for S0273
- 2007-04-01: S0273 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code S0273?
S0273 is the HCPCS Level II code for physician visit at member's home, outside of a capitation arrangement. Short descriptor: "Md home visit outside cap".
Does Medicare cover S0273?
Coverage code I — Not payable by Medicare. Medicare does not pay separately under this code; another code applies.
Related S02 codes
- S0201 — Partial hospitalization services, less than 24 hours, per diem
- S0207 — Paramedic intercept, non-hospital-based als service (non-voluntary), non-transport
- S0208 — Paramedic intercept, hospital-based als service (non-voluntary), non-transport
- S0209 — Wheelchair van, mileage, per mile
- S0215 — Non-emergency transportation; mileage, per mile
- S0220 — Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient is present); approximately 30 minutes
- S0221 — Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient is present); approximately 60 minutes
- S0250 — Comprehensive geriatric assessment and treatment planning performed by assessment team
- S0255 — Hospice referral visit (advising patient and family of care options) performed by nurse, social worker, or other designated staff
- S0257 — Counseling and discussion regarding advance directives or end of life care planning and decisions, with patient and/or surrogate (list separately in addition to code for appropriate evaluation and management service)
- S0260 — History and physical (outpatient or office) related to surgical procedure (list separately in addition to code for appropriate evaluation and management service)
- S0265 — Genetic counseling, under physician supervision, each 15 minutes
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Next steps
- Run a reimbursement report for a device billed under S0273
- Watch S0273 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for S0273
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.