S9366 Hit tpn 2 liter diem

Home infusion therapy, total parenteral nutrition (tpn); more than one liter but no more than two liters per day, 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

Medicare pricing for S9366

Physician Fee Schedule (CY 2026, RVU26D)

Status I: not valid for Medicare (Medicare uses another code).

Payer policies and prior authorization for S9366

4 of 4 payer prior-auth lists that name S9366 require prior authorization or set conditions: Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Texas, Rocky Mountain Health Plans.

PayerPlanStatePrior authConditionsSinceSource
Blue Cross and Blue Shield of IllinoisBlue Cross Community MMAI (Medicare-Medicaid Alignment Initiative)ILprior auth requiredJan 1, 2025Procedure Code List, Effective 1/1/2025
Blue Cross and Blue Shield of TexasTexas PA exemption (gold card), outpatient, fully insuredTXprior auth requiredGold-card exemption availableJul 1, 2026BCBSTX Outpatient Prior Authorization Exemption Clinical Guidelines (max units, PA exempt date range)
Rocky Mountain Health PlansRocky Mountain Health Plans CHP+COprior auth requiredOct 1, 2026Rocky Mountain Children’s Health Plan - prior authorization Effective October 1, 2026
Rocky Mountain Health PlansRocky Mountain Medicare Advantage D-SNPCOprior auth requiredFeb 1, 2025Rocky Mountain Health Plans Medicare Advantage Dual-Special Needs Plans – prior authorization Effective February 1, 2025

Payer coverage policies that name S9366

S9366 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.

PayerPolicyRole in policyReviewedDocument
AetnaGrowth Hormone (GH) and Growth Hormone Antagonists (0170)listed, no stance (range S9364-S9368)Jun 26, 2026payer document
AetnaHome Health Aides (0218)listed, no stance (range S9325-S9379)Sep 10, 2026payer document
AetnaIntestinal Rehabilitation Programs (0342)listed, no stance (range S9364-S9368)May 21, 2026payer document
AetnaIntestinal Transplantation (0605)listed, no stance (range S9364-S9368)Sep 3, 2026payer document
AetnaNutritional Support (0061)
Enteral lactoferrin supplementation
covered if criteria are metJan 15, 2026payer document
AetnaNutritional Support (0061)listed, no stanceJan 15, 2026payer document
AnthemHome Health (CG-MED-23)covered if criteria are met (range S9364-S9368)Nov 6, 2025payer document
AnthemHome Parenteral Nutrition (CG-MED-89)covered if criteria are metMay 14, 2026payer document
Blue Cross & Blue Shield of MississippiParenteral Pen And Enteral En Nutrition Support In The Home (L.1.01.404)covered if criteria are metpayer document
Blue Cross Blue Shield of MassachusettsTPN (296)listed, no stancepayer document
CenteneTotal Parenteral Nutrition and Intradialytic Parenteral Nutrition Reference Number: CP.MP.163 (CP.MP.163)covered if criteria are metJan 1, 2026payer 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 stanceJan 1, 2026payer document
UnitedHealthcareHome Health Care Services (for Kentucky Only) (CS137KY.12)listed, no stanceJul 1, 2026payer document
UnitedHealthcareHome Health, Skilled, and Custodial Care Services (MP.022.28)listed, no stanceJul 1, 2026payer document
UnitedHealthcareHome Health, Skilled, and Custodial Care Services (CS137.X)listed, no stanceJul 1, 2026payer document
UnitedHealthcareHome Health, Skilled, and Custodial Care Services (for Kansas Only) (CS137KS.04)listed, no stanceSep 1, 2026payer document
UnitedHealthcareHome Health, Skilled, and Custodial Care Services (for Nebraska Only) (CS137NE.V)listed, no stanceJan 1, 2026payer document
UnitedHealthcareHome Health, Skilled, and Custodial Care Services (for New Mexico Only) (CS137NM.D)listed, no stanceSep 1, 2026payer document
UnitedHealthcareHome Health, Skilled, and Custodial Care Services (for Ohio Only) (CS137OH.E)listed, no stanceAug 1, 2026payer document
UnitedHealthcareHome Health, Skilled, and Custodial Care Services (for Tennessee Only) (CS137TN1.J)listed, no stanceJan 1, 2026payer document

Recent prior-auth changes

  • Jan 1, 2026: PA removed, Blue Cross and Blue Shield of Illinois
  • Jan 1, 2026: PA removed, Blue Cross and Blue Shield of Illinois
  • Feb 28, 2025: PA removed, Cigna
  • Feb 28, 2025: PA removed, Cigna
  • Feb 28, 2025: PA removed, Cigna

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • KY: $110.00 (dme), effective Jan 1, 2026
  • MA: $43.95 (dme_rates), effective Mar 1, 2026
  • ND: $0.00 (physician), effective Aug 1, 2026
  • VA: $48.80 (dme), effective Dec 1, 2026

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.