S9497 HCPCS code: Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 3 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem
S9497 is the HCPCS Level II code for home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 3 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), 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 | 2002-01-01 |
| Last action effective | 2002-01-01 |
What changed for S9497
- 2002-01-01: S9497 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 S9497?
S9497 is the HCPCS Level II code for home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 3 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem. Short descriptor: "Hit antibiotic q3h diem".
Does Medicare cover S9497?
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 S9497
- Watch S9497 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for S9497
Sources: CMS HCPCS Level II release October 2026; 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.