Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHCPCS S9131 Fee Schedule
Last Verified: October 2026
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.
Physical therapy; in the home, per diem
| Key Fact | Detail |
|---|---|
| Service Type | Temporary National Codes (Non-Medicare) Miscellaneous Supplies and Services |
| Common Place of Service | 99 - Other POS |
| Complexity Level | Low |
| Medicaid Fee Schedule | $79.21 median of the 2 states in the free preview · View Medicaid rates for S9131 |
National average reimbursement for HCPCS S9131 by major payers:
$120.75
$102.92
$80.60
$119.25
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS S9131.
HCPCS S9131
5 of 25 sample ratesHigher to lower in this preview
Bwb Sunbelt Home Health Services LLC, Centerwell Home Health
$145.00Published rateCaregivers Pb, Inc
$110.00Published rateAlways Caring Home Care Services, Inc
$95.00Published rateHome Healthcare Nursing, LLC, Home Nursing
Home Healthcare Nursing LLC
$90.00Published rateOdp Management, LLC, D'Oro Primary Home Care Services
Odp Management LLC
$90.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS S9131 vs. Other Miscellaneous Supplies and Services Codes
The HCPCS S9131 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 S9131 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 |
|---|---|---|
| S9129-HCPCS | Low | Occupational therapy, in the home, per diem |
| S9131-HCPCS | Low | Physical therapy; in the home, per diem |
| S9140-HCPCS | Low | Diabetic management program, follow-up visit to non-MD provider |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS S9131. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the S9131 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS S9131) and we'll show you how you compare in 15 minutes or less.