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 S9504 Fee Schedule
Last Verified: September 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, antibiotic, antiviral, or antifungal; once every 4 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem
| Key Fact | Detail |
|---|---|
| Service Type | Temporary National Codes (Non-Medicare) Home Therapy Services |
| Common Place of Service | None 99 - Other POS |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for S9504 |
National average reimbursement for HCPCS S9504 by major payers:
$80.99
$70.00
$25.00
$79.50
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS S9504.
HCPCS S9504
5 of 25 sample ratesHigher to lower in this preview
Banner Home Care-Arizona
$150.00Published rateBig Bend Infusion LLC, Vital Care Of Tallahassee
Big Bend Infusion LLC
$50.00Published rateBayside Infusion Services, LLC
Bayside Infusion Services LLC
$50.00Published rateBayside Infusion Services, LLC
Bayside Infusion Services LLC
$45.00Published rateBehavioral And Speech Institute Inc
$35.00Published 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 S9504 vs. Other Home Therapy Services Codes
The HCPCS S9504 code is part of the Temporary National Codes (Non-Medicare) services used for Home Therapy 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 S9504 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 |
|---|---|---|
| S9503-HCPCS | Low | Home infusion therapy, antibiotic, antiviral, or antifungal; once every 6 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
| S9504-HCPCS | Low | Home infusion therapy, antibiotic, antiviral, or antifungal; once every 4 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
| S9529-HCPCS | Low | Routine venipuncture for collection of specimen(s), single home bound, nursing home, or skilled nursing facility patient |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS S9504. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the S9504 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 S9504) and we'll show you how you compare in 15 minutes or less.