HCPCS S9123 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Temporary National Codes (Non-Medicare) • Miscellaneous Supplies and Services |
| Common Place of Service | • None • 99 - Other POS |
| Complexity Level | Low |
National average reimbursement for HCPCS S9123 by major payers:

$61.09

$54.21

$36.31

$37.09
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS S9123 | ||||||
United | S9123 | $55.00 | 1720251440 - GIBRALTAR HOME HEALTH SERVICES, LLC | 20779880 | CA | Home Health Agency (251E00000X) |
United | S9123 | $55.00 | 1265722599 - TOTAL CARE HOME HEALTH SERVICES INC. | 900647636 - (CA) TOTAL CARE HOME HEALTH SERVICES INC | CA | Home Health Agency (251E00000X) |
United | S9123 | $77.50 | 1689943243 - PROHEALTH HOME CARE INC | 421733324 - (CA) PROHEALTH HOME CARE INC | CA | Home Health Agency (251E00000X) |
United | S9123 | $55.00 | 1326032137 - GRACE HOME HEALTH CARE, GRACE HOME HEALTH CARE, INC. | 954528583 - (CA) GRACE HOME HEALTH CARE INC | CA | Home Health Agency (251E00000X) |
United | S9123 | $70.00 | 1316368954 - CALIFORNIA HEALTHCARE MANAGEMENT GROUP, INC | 464162871 - (CA) CALIFORNIA HEALTHCARE MANAGEMENT GROUP INC | CA | Home Health Agency (251E00000X) |
United | S9123 | $62.00 | 1336538495 - ASSISTED HOME RECOVERY, INC., ASSISTED HOME CARE | 954242428 - ASSISTED HOME RECOVERY, INC. | CA | Home Health Agency (251E00000X) |
United | S9123 | $75.00 | 1538228218 - TENDER LOVING CARE HEALTH CARE SERVICES WESTERN, LLC, AMEDISYS HOME HEALTH CARE | 731709953 - (CA) TENDER LOVING CARE HEALTH CARE SERVICES WESTERN LLC | CA | Home Health Agency (251E00000X) |
United | S9123 | $60.00 | 1992943161 - CARECHOICES HOME HEALTH SERVICES LLC | 300521249 - (CA) CARECHOICES HOME HEALTH SERVICES, INC. | CA | Home Health Agency (251E00000X) |
United | S9123 | $55.00 | 1396193546 - PACIFIC POINT HEALTH CARE SERVICES INC, PACIFIC POINT HOME HEALTH & PALLIATIVE CARE | 812497904 - (CA) PACIFIC POINT HEALTHCARE SERVICES, INC. | CA | Home Health Agency (251E00000X) |
United | S9123 | $57.50 | 1104058122 - PREMIER HEALTHCARE SERVICES, LLC, AVEANNA HEALTHCARE | 204078036 - PREMIER HEALTHCARE SERVICES, LLC | CA | Home Health Agency (251E00000X) |
United | S9123 | $60.00 | 1326272766 - MSJ HEALTHCARE LLC, GRANDCARE HOME HEALTH SERVICES | 264584774 | CA | Home Health Agency (251E00000X) |
United | S9123 | $77.50 | 1215375175 - PROHEALTH HOME CARE, INC | 421733324 - (CA) PROHEALTH HOME CARE INC | CA | Home Health Agency (251E00000X) |
United | S9123 | $70.00 | 1174520027 - UNITED HOMECARE OF NORTHERN CALIFORNIA, LC | 870629425 | CA | Home Health Agency (251E00000X) |
United | S9123 | $55.00 | 1841329273 - CALIFORNIAS BEST HOME HEALTH SERVICES, INC | 208400782 - (CA) CALIFORNIAS BEST HOME HEALTH SERVICES INC | CA | Home Health Agency (251E00000X) |
United | S9123 | $70.00 | 1285822908 - UNI CARE HOME HEALTH INC. | 331165611 - (CA) UNI CARE HOME HEALTH INC | CA | Home Health Agency (251E00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS S9123 vs. Other Miscellaneous Supplies and Services Codes
The HCPCS S9123 code is part of the Temporary National Codes (Non-Medicare) services used for Miscellaneous Supplies and Services. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS S9123 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| S9122-HCPCS | Low | Home health aide or certified nurse assistant, providing care in the home; per hour |
| S9123-HCPCS | Low | Nursing care, in the home; by registered nurse, per hour |
| S9124-HCPCS | Low | Nursing care, in the home; by licensed practical nurse, per hour |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS S9123. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the S9123 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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