Summary & Overview
HCPCS Level II S8097: Asthma Kit with Peak Flow Meter and Spacer
HCPCS Level II code S8097 represents an asthma kit composed of items such as a portable peak expiratory flow meter, instructional video, brochure, and/or spacer. Nationally, this code is used to bill for the provision of educational and self-management supplies that support asthma control, patient monitoring, and inhaler technique outside of purely clinical procedures. Use of this code matters as health systems and payers emphasize value-based care, self-management education, and reduced acute utilization for asthma.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for issuing an asthma kit, common sites of service where the kit is furnished, and typical payer coverage considerations. The publication outlines benchmarks and policy-relevant factors affecting coverage and billing for supply-based asthma education, highlights coding touchpoints for claims submission, and summarizes areas where payers commonly require documentation or limits for supplies.
This summary is intended for a national audience of billing professionals, clinicians involved in asthma care, and policy analysts seeking clarity on the role of S8097 in outpatient and community-based asthma management programs. Data not available in the input.
Billing Code Overview
HCPCS Level II code S8097 describes an asthma kit that may include items such as a portable peak expiratory flow meter, instructional video, brochure, and/or spacer. The service represented is provision of an educational and self-management kit for patients with asthma, designed to support home or outpatient self-monitoring and inhaler technique.
Typical site of service for this supply-based patient education kit is outpatient clinics, primary care or specialty offices, community health settings, and patient homes when provided as part of a discharge or outpatient education program.
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Clinical & Coding Specifications
Clinical Context
A school-aged patient with a history of persistent asthma presents to a primary care clinic for routine follow-up and asthma self-management education. The clinician reviews recent symptoms, inhaler technique, and frequency of rescue inhaler use. The clinician determines the patient would benefit from a take-home asthma kit that includes a portable peak expiratory flow (PEF) meter, spacer, instructional brochure, and an educational video link. The kit is provided at the conclusion of the visit along with demonstration and return demonstration of PEF measurement and spacer/inhaler technique. Nursing documents kit components dispensed, lot numbers if applicable, patient/caregiver education provided, and that the caregiver demonstrated correct use. The typical workflow: clinician assessment → education session with nurse or respiratory therapist → device demonstration → issuance of S8097 kit and documentation in the medical record. Typical sites of service include outpatient clinics, primary care offices, pediatric clinics, school-based health centers, and community health programs.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier (default) | Use when no specific modifier applies and kit is billed without special circumstances. |