`S9996` Meals for clinical trial par

Meals for clinical trial participant and one caregiver/companion

Medicare coverage: Not payable by Medicare
Status: active (October 2026 file)

Medicare pricing for S9996

Physician Fee Schedule (CY 2026, RVU26D)

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

Payer policies and prior authorization for S9996

6 of 6 payer prior-auth lists that name S9996 require prior authorization or set conditions: Blue Shield of California, UnitedHealthcare Community Plan.

Payer	Plan	State	Prior auth	Since	Source
Blue Shield of California	Blue Shield Medicare	CA	prior auth required	Sep 1, 2026	Prior Authorization List for Blue Shield Medicare
Blue Shield of California	Blue Shield commercial	CA	prior auth required	Sep 1, 2026	Prior Authorization List for Blue Shield
UnitedHealthcare Community Plan	AHCCCS Complete Care (ACC)	AZ	prior auth required	Oct 1, 2026	Prior authorization requirements for AHCCCS Complete Care (ACC) Medicaid effective October 1, 2026
UnitedHealthcare Community Plan	ALTCS Developmentally Disabled	AZ	prior auth required	Oct 1, 2026	Prior authorization requirements for Arizona Developmental Disabilities Effective October 1, 2026
UnitedHealthcare Community Plan	ALTCS Long Term Care	AZ	prior auth required	Oct 1, 2026	Prior authorization requirements for Arizona Long Term Care Effective October 1, 2026
UnitedHealthcare Community Plan	New Mexico Turquoise Care	NM	prior auth required	Oct 1, 2026	Prior authorization requirements for UnitedHealthcare Community Plan of New Mexico Effective October 1, 2026

Payer coverage policies that name S9996

S9996 appears in 14 coverage policies from Aetna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Molina Healthcare, Premera Blue Cross, UnitedHealthcare.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Clinical Trials, Coverage of Routine Patient Care Costs (0466)	not covered	Jul 1, 2026	payer 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 stance	Dec 15, 2025	payer document
Molina Healthcare	RELATED POLICIES MCP-000: Evaluation of New Technology MCP-184: Experimental and Investigational Services	listed, no stance		payer document
Premera Blue Cross	Non-covered Services and Procedures Page \| 20 of 30 \| ∞	not covered	Jun 1, 2026	payer document
UnitedHealthcare	Clinical Trials (MP.006.27) Not Covered	listed, no stance	Sep 1, 2026	payer document
UnitedHealthcare	Mandatory Medicaid Coverage of Routine Patient Costs in Qualifying Clinical Trials (CS018SS.V) Not Covered	listed, no stance	Aug 1, 2026	payer document
UnitedHealthcare	Mandatory Medicaid Coverage of Routine Patient Costs in Qualifying Clinical Trials (for Idaho Only) (CS018ID.C) Not Covered	listed, no stance	Sep 1, 2026	payer document
UnitedHealthcare	Mandatory Medicaid Coverage of Routine Patient Costs in Qualifying Clinical Trials (for Kansas Only) (CS018KS.03) Not Covered	listed, no stance	Aug 1, 2026	payer document
UnitedHealthcare	Mandatory Medicaid Coverage of Routine Patient Costs in Qualifying Clinical Trials (for Kentucky Only) (CS018KY.06) Not Covered	listed, no stance	Sep 1, 2025	payer document
UnitedHealthcare	Mandatory Medicaid Coverage of Routine Patient Costs in Qualifying Clinical Trials (for Nebraska Only) (CS018NE.W) Not Covered	listed, no stance	Sep 1, 2026	payer document
UnitedHealthcare	Mandatory Medicaid Coverage of Routine Patient Costs in Qualifying Clinical Trials (for New Mexico Only) (CS018NM.D) Not Covered	listed, no stance	Aug 1, 2026	payer document
UnitedHealthcare	Mandatory Medicaid Coverage of Routine Patient Costs in Qualifying Clinical Trials (for Ohio Only) (CS018OH.C) Not Covered	listed, no stance	Oct 1, 2025	payer document
UnitedHealthcare	Mandatory Medicaid Coverage of Routine Patient Costs in Qualifying Clinical Trials (for Pennsylvania Only) (CS018PA.T) Not Covered	listed, no stance	Sep 1, 2026	payer document
UnitedHealthcare	Mandatory Medicaid Coverage of Routine Patient Costs in Qualifying Clinical Trials (for Tennessee Only) (CS018TN.T) Not Covered	listed, no stance	Sep 1, 2026	payer 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.

S9996 Meals for clinical trial par