HCPCS S9123: Nursing Care in Home by Registered Nurse, Per Hour
HCPCS Level II code S9123 describes nursing care provided in the home by a registered nurse, billed per hour; the service type is skilled nursing services and the typical site of service is the patient's home for general nursing care when CPT home visit codes 99500–99602 are not applicable.
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National Reimbursement Benchmarks
Commercial reimbursement for HCPCS S9123 centers around a BUCA average commercial rate of $53.7, with notable payer-specific spreads. Blue Cross Blue Shield shows a wide interquartile range (P75–P25) of $14.1 ($64.3–$50.2), and Cigna displays an even wider IQR of $50.0 ($64.0–$14.0), indicating substantial variability within those contracts. UnitedHealth Group and Aetna are comparatively tight: UnitedHealth Group’s IQR is $5.5 ($61.0–$55.5) and Aetna’s IQR is effectively $0.0 ($30.0–$30.0), reflecting clustered commercial pricing for those payers.
Maximum-to-minimum spreads also highlight dispersion: Cigna has a high ceiling ($213.4) well above its $14.0 floor, while Blue Cross Blue Shield’s max of $112.5 sits mid-range versus its $28.4 minimum. UnitedHealth Group’s values are concentrated near its median ($61.0) and BUCA’s mean represents a mid-market commercial benchmark at $53.7.