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See a sample rate comparisonHCPCS S9325 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.
Home infusion therapy, pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment, (drugs and nursing visits coded separately), per diem (do not use this code with S9326, S9327 or S9328)
| Key Fact | Detail |
|---|---|
| Service Type | Temporary National Codes (Non-Medicare) Home Infusion Therapy |
| Common Place of Service | 99 - Other POS |
| Complexity Level | Low |
| Medicaid Fee Schedule | $61.165 median of the 2 states in the free preview · View Medicaid rates for S9325 |
National average reimbursement for HCPCS S9325 by major payers:
$75.00
$70.00
$25.00
$96.00
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HCPCS S9325
5 of 25 sample ratesHigher to lower in this preview
Coram Healthcare Corporation Of Florida
$85.00Published rateBioscrip Infusion Services, LLC
$65.00Published rateOption Care Enterprises, Inc.
Option Care Health, Inc.
$65.00Published rateOption Care Enterprises, Inc.
Option Care Health, Inc.
$65.00Published rateOption Care Enterprises, Inc.
Option Care Health, Inc.
$65.00Published rate
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See a sample payer proposalHCPCS S9325 vs. Other Home Infusion Therapy Codes
The HCPCS S9325 code is part of the Temporary National Codes (Non-Medicare) services used for Home Infusion Therapy. 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 S9325 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 |
|---|---|---|
| S9214-HCPCS | Low | Home management of gestational diabetes, includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately); per diem (do not use this code with any home infusion per diem code) |
| S9325-HCPCS | Low | Home infusion therapy, pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment, (drugs and nursing visits coded separately), per diem (do not use this code with S9326, S9327 or S9328) |
| S9326-HCPCS | Low | Home infusion therapy, continuous (twenty-four hours or more) pain management infusion; administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS S9325. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the S9325 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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