S9475 HCPCS code: Ambulatory setting substance abuse treatment or detoxification services, per diem
S9475 is the HCPCS Level II code for ambulatory setting substance abuse treatment or detoxification services, per diem. 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 | 2000-01-01 |
| Last action effective | 2000-01-01 |
What changed for S9475
- 2000-01-01: S9475 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 S9475?
S9475 is the HCPCS Level II code for ambulatory setting substance abuse treatment or detoxification services, per diem. Short descriptor: "Ambulatory setting substance".
Does Medicare cover S9475?
Coverage code I — Not payable by Medicare. Medicare does not pay separately under this code; another code applies.
Related S94 codes
- S9401 — Anticoagulation clinic, inclusive of all services except laboratory tests, per session
- S9430 — Pharmacy compounding and dispensing services
- S9432 — Medical foods for non-inborn errors of metabolism
- S9433 — Medical food nutritionally complete, administered orally, providing 100% of nutritional intake
- S9434 — Modified solid food supplements for inborn errors of metabolism
- S9435 — Medical foods for inborn errors of metabolism
- S9436 — Childbirth preparation/lamaze classes, non-physician provider, per session
- S9437 — Childbirth refresher classes, non-physician provider, per session
- S9438 — Cesarean birth classes, non-physician provider, per session
- S9439 — Vbac (vaginal birth after cesarean) classes, non-physician provider, per session
- S9441 — Asthma education, non-physician provider, per session
- S9442 — Birthing classes, non-physician provider, per session
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Next steps
- Run a reimbursement report for a device billed under S9475
- Watch S9475 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for S9475
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.