S9364 Hit tpn total diemHome infusion therapy, total parenteral nutrition (tpn); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem (do not use with home infusion codes s9365-s9368 using daily volume scales)
Status I: not valid for Medicare (Medicare uses another code).
3 of 3 payer prior-auth lists that name S9364 require prior authorization or set conditions: Blue Cross and Blue Shield of Texas, Rocky Mountain Health Plans.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Blue Cross and Blue Shield of Texas | Texas PA exemption (gold card), outpatient, fully insured | TX | prior auth required | Gold-card exemption available | Jul 1, 2026 | BCBSTX Outpatient Prior Authorization Exemption Clinical Guidelines (max units, PA exempt date range) |
| Rocky Mountain Health Plans | Rocky Mountain Health Plans CHP+ | CO | prior auth required | Oct 1, 2026 | Rocky Mountain Children’s Health Plan - prior authorization Effective October 1, 2026 | |
| Rocky Mountain Health Plans | Rocky Mountain Medicare Advantage D-SNP | CO | prior auth required | Feb 1, 2025 | Rocky Mountain Health Plans Medicare Advantage Dual-Special Needs Plans – prior authorization Effective February 1, 2025 |
S9364 appears in 19 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, Centene, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Growth Hormone (GH) and Growth Hormone Antagonists (0170) | listed, no stance (range S9364-S9368) | Jun 26, 2026 | payer document |
| Aetna | Home Health Aides (0218) | listed, no stance (range S9325-S9379) | Sep 10, 2026 | payer document |
| Aetna | Intestinal Rehabilitation Programs (0342) | listed, no stance (range S9364-S9368) | May 21, 2026 | payer document |
| Aetna | Intestinal Transplantation (0605) | listed, no stance (range S9364-S9368) | Sep 3, 2026 | payer document |
| Aetna | Nutritional Support (0061) Enteral lactoferrin supplementation | covered if criteria are met | Jan 15, 2026 | payer document |
| Aetna | Nutritional Support (0061) | listed, no stance | Jan 15, 2026 | payer document |
| Anthem | Home Health (CG-MED-23) | covered if criteria are met (range S9364-S9368) | Nov 6, 2025 | payer document |
| Anthem | Home Parenteral Nutrition (CG-MED-89) | covered if criteria are met | May 14, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Parenteral Pen And Enteral En Nutrition Support In The Home (L.1.01.404) | covered if criteria are met | payer document | |
| Blue Cross Blue Shield of Massachusetts | TPN (296) | listed, no stance | payer document | |
| Centene | Total Parenteral Nutrition and Intradialytic Parenteral Nutrition Reference Number: CP.MP.163 (CP.MP.163) | covered if criteria are met | Jan 1, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Nutritional Support (MED201.011) HCPCS Codes B4034, B4035, B4036, B4081, B4082, B4083, B4087, B4088, B4102, | listed, no stance | Jan 1, 2026 | payer document |
| UnitedHealthcare | Home Health Care Services (for Kentucky Only) (CS137KY.12) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Home Health, Skilled, and Custodial Care Services (MP.022.28) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Home Health, Skilled, and Custodial Care Services (CS137.X) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Home Health, Skilled, and Custodial Care Services (for Kansas Only) (CS137KS.04) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Home Health, Skilled, and Custodial Care Services (for Nebraska Only) (CS137NE.V) | listed, no stance | Jan 1, 2026 | payer document |
| UnitedHealthcare | Home Health, Skilled, and Custodial Care Services (for New Mexico Only) (CS137NM.D) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Home Health, Skilled, and Custodial Care Services (for Ohio Only) (CS137OH.E) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Home Health, Skilled, and Custodial Care Services (for Tennessee Only) (CS137TN1.J) | listed, no stance | Jan 1, 2026 | payer document |
Prior authorization required or conditional in IN.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.