S9992 Transportation costs to and

Transportation costs to and from trial location and local transportation costs (e.g., fares for taxicab or bus) for clinical trial participant and one caregiver/companion

Medicare pricing for S9992

Physician Fee Schedule (CY 2026, RVU26D)

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

Payer policies and prior authorization for S9992

6 of 6 payer prior-auth lists that name S9992 require prior authorization or set conditions: Blue Shield of California, UnitedHealthcare Community Plan.

PayerPlanStatePrior authConditionsSinceSource
Blue Shield of CaliforniaBlue Shield MedicareCAprior auth requiredSep 1, 2026Prior Authorization List for Blue Shield Medicare
Blue Shield of CaliforniaBlue Shield commercialCAprior auth requiredSep 1, 2026Prior Authorization List for Blue Shield
UnitedHealthcare Community PlanAHCCCS Complete Care (ACC)AZprior auth requiredOct 1, 2026Prior authorization requirements for AHCCCS Complete Care (ACC) Medicaid effective October 1, 2026
UnitedHealthcare Community PlanALTCS Developmentally DisabledAZprior auth requiredOct 1, 2026Prior authorization requirements for Arizona Developmental Disabilities Effective October 1, 2026
UnitedHealthcare Community PlanALTCS Long Term CareAZprior auth requiredOct 1, 2026Prior authorization requirements for Arizona Long Term Care Effective October 1, 2026
UnitedHealthcare Community PlanNew Mexico Turquoise CareNMprior auth requiredOct 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of New Mexico Effective October 1, 2026

Payer coverage policies that name S9992

S9992 appears in 14 coverage policies from Aetna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Molina Healthcare, Premera Blue Cross, UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
AetnaClinical Trials, Coverage of Routine Patient Care Costs (0466)not coveredJul 1, 2026payer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)Clinical Trial Treatment or Therapy
HCPCS Codes G0276, G0293, G0294, G9057, G9537, M1396, M1404, S9988, S9990,
listed, no stanceDec 15, 2025payer document
Molina HealthcareRELATED POLICIES MCP-000: Evaluation of New Technology MCP-184: Experimental and Investigational Serviceslisted, no stancepayer document
Premera Blue CrossNon-covered Services and Procedures
Page | 20 of 30 | ∞
not coveredJun 1, 2026payer document
UnitedHealthcareClinical Trials (MP.006.27)
Not Covered
listed, no stanceSep 1, 2026payer document
UnitedHealthcareMandatory Medicaid Coverage of Routine Patient Costs in Qualifying Clinical Trials (CS018SS.V)
Not Covered
listed, no stanceAug 1, 2026payer document
UnitedHealthcareMandatory Medicaid Coverage of Routine Patient Costs in Qualifying Clinical Trials (for Idaho Only) (CS018ID.C)
Not Covered
listed, no stanceSep 1, 2026payer document
UnitedHealthcareMandatory Medicaid Coverage of Routine Patient Costs in Qualifying Clinical Trials (for Kansas Only) (CS018KS.03)
Not Covered
listed, no stanceAug 1, 2026payer document
UnitedHealthcareMandatory Medicaid Coverage of Routine Patient Costs in Qualifying Clinical Trials (for Kentucky Only) (CS018KY.06)
Not Covered
listed, no stanceSep 1, 2025payer document
UnitedHealthcareMandatory Medicaid Coverage of Routine Patient Costs in Qualifying Clinical Trials (for Nebraska Only) (CS018NE.W)
Not Covered
listed, no stanceSep 1, 2026payer document
UnitedHealthcareMandatory Medicaid Coverage of Routine Patient Costs in Qualifying Clinical Trials (for New Mexico Only) (CS018NM.D)
Not Covered
listed, no stanceAug 1, 2026payer document
UnitedHealthcareMandatory Medicaid Coverage of Routine Patient Costs in Qualifying Clinical Trials (for Ohio Only) (CS018OH.C)
Not Covered
listed, no stanceOct 1, 2025payer document
UnitedHealthcareMandatory Medicaid Coverage of Routine Patient Costs in Qualifying Clinical Trials (for Pennsylvania Only) (CS018PA.T)
Not Covered
listed, no stanceSep 1, 2026payer document
UnitedHealthcareMandatory Medicaid Coverage of Routine Patient Costs in Qualifying Clinical Trials (for Tennessee Only) (CS018TN.T)
Not Covered
listed, no stanceSep 1, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • ND: $0.00 (physician), effective Aug 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.