S9810 Ht pharm per hourHome therapy; professional pharmacy services for provision of infusion, specialty drug administration, and/or disease state management, not otherwise classified, per hour (do not use this code with any per diem code)
Status I: not valid for Medicare (Medicare uses another code).
1 of 1 payer prior-auth lists that name S9810 require prior authorization or set conditions: Blue Cross and Blue Shield of Texas.
| 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) |
S9810 appears in 5 coverage policies from Aetna, Anthem, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT).
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Home Health Aides (0218) | listed, no stance (range S9490-S9810) | Sep 10, 2026 | payer document |
| Aetna | Nutritional Support (0061) | listed, no stance | Jan 15, 2026 | payer document |
| Aetna | Skilled Home Private Duty Nursing Care (0136) | listed, no stance (range S9490-S9810) | Apr 7, 2026 | payer document |
| Anthem | Home Health (CG-MED-23) | covered if criteria are met | Nov 6, 2025 | 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 |
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.