S9986 HCPCS code: Not medically necessary service (patient is aware that service not medically necessary)
S9986 is the HCPCS Level II code for not medically necessary service (patient is aware that service not medically necessary). 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 S9986
- 2002-01-01: S9986 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 S9986?
S9986 is the HCPCS Level II code for not medically necessary service (patient is aware that service not medically necessary). Short descriptor: "Not medically necessary svc".
Does Medicare cover S9986?
Coverage code I — Not payable by Medicare. Medicare does not pay separately under this code; another code applies.
Related S99 codes
- S9900 — Services by a journal-listed christian science practitioner for the purpose of healing, per diem
- S9901 — Services by a journal-listed christian science nurse, per hour
- S9960 — Ambulance service, conventional air service, nonemergency transport, one way (fixed wing)
- S9961 — Ambulance service, conventional air service, nonemergency transport, one way (rotary wing)
- S9970 — Health club membership, annual
- S9975 — Transplant related lodging, meals and transportation, per diem
- S9976 — Lodging, per diem, not otherwise classified
- S9977 — Meals, per diem, not otherwise specified
- S9981 — Medical records copying fee, administrative
- S9982 — Medical records copying fee, per page
- S9988 — Services provided as part of a phase i clinical trial
- S9989 — Services provided outside of the united states of america (list in addition to code(s) for service(s))
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Next steps
- Run a reimbursement report for a device billed under S9986
- Watch S9986 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for S9986
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.