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HCPCS S9124: Nursing Care in Home by Licensed Practical Nurse, Hourly

HCPCS Level II code S9124 represents hourly nursing care delivered in the patient's home by a licensed practical nurse. This code captures a common component of home-based skilled nursing services and is used by payers and providers to document and bill for hands-on nursing care performed outside institutional settings. Nationally, home-based nursing codes matter for access to post-acute care, care continuity for patients with mobility limitations, and cost and utilization tracking across payers.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of typical billing contexts for S9124, comparisons to related home-care service codes, and discussion of clinical settings where licensed practical nurse hourly visits are commonly applied. The publication also outlines common ICD-10 diagnostic contexts associated with home nursing visits and highlights how S9124 interacts with other home-visit codes for nursing and supportive services.

This summary provides a national perspective on where and why HCPCS Level II code S9124 is used, what services it represents, and what readers can expect in the full publication: benchmarks and utilization patterns, payer coverage considerations, and clinical contexts relevant to home-based licensed practical nursing services.

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Billing Code Overview

HCPCS Level II code S9124 denotes nursing care provided in the patient's home by a licensed practical nurse, billed on an hourly basis. The service type is skilled nursing care delivered by a licensed practical nurse. The typical site of service is the patient's residence or home setting where in-home nursing services are furnished.

National Reimbursement Benchmarks

Commercial reimbursement for HCPCS S9124 centers around an average commercial benchmark (BUCA) of $33.30, with individual payers showing meaningful variation. Blue Cross Blue Shield (BCBS) and Aetna book higher central tendencies — BCBS median $37.20 and Aetna a uniform $30.00 — while Cigna and UnitedHealth Group present lower medians at $11.10 and $9.80, respectively. BUCA’s mean of $33.30 sits between the higher BCBS values and the lower Cigna/UnitedHealth Group medians, indicating the commercial-market midpoint for this code.

Rate dispersion (P75 minus P25) highlights concentration differences: UnitedHealth Group shows the widest interquartile spread at $40.00 (P75 $40.00 minus P25 $0.00), followed by BCBS at $17.80 and BUCA at $18.90. Aetna is the tightest with no dispersion (P75 $30.00 minus P25 $30.00 = $0.00), and Cigna’s spread is $13.90. These spreads illustrate which payers concentrate around a narrow band versus those with broader commercial variability.

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HCPCS S9124: Nursing Care in Home by Licensed Practical Nurse, Hourly

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Billing Code Overview

National Reimbursement Benchmarks

National Payer Mean Reimbursement Rates

Clinical & Coding Specifications

Clinical Context

A 78-year-old patient lives at home with long-term dependence on a wheelchair (Z99.3) and recent bed confinement (Z74.01) following a hip fracture and surgical repair. The patient is on long-term anticoagulation (Z79.01) and requires routine therapeutic drug level monitoring (Z51.81) and wound/aftercare follow-up (Z48.89). A home health agency dispatches a licensed practical nurse to provide episodic skilled nursing care, assisting with medication administration, subcutaneous injections, wound dressing changes, basic assessments of vital signs and mobility, and reporting changes to the supervising clinician.

The clinical workflow begins with a physician or nurse practitioner order for home nursing visits. The home health agency schedules visits and assigns a licensed practical nurse (163W00000X) or community health LPN (163WC1500X) to perform one-hour skilled nursing episodes billed with S9124. The LPN documents time on task, clinical findings, care provided (medication administration, wound care, education), and communicates any abnormal findings to the supervising registered nurse or ordering provider. Billing includes the appropriate payer and may append modifiers for circumstances such as bilateral services, reduced or discontinued services, or professional component adjustments when applicable. Typical payors include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.

Coding Specifications

Modifier	Description	When to Use
`59`	Distinct procedural service	When a separately identifiable nursing service is provided on the same day as another service and must be distinguished
`52`	Reduced services	When the LPN performs a reduced or partially completed visit due to patient refusal or early termination
`53`	Discontinued procedure	When the visit is started but discontinued for patient safety or clinical reasons
`76`	Repeat procedure by same provider	When a nursing visit is repeated on the same day by the same provider for the same patient
`78`	Unplanned return to the same service/procedure during postoperative period	When an unplanned home nursing return visit is required for a postoperative complication within the global period
`22`	Increased procedural services	Rarely used; when care required is substantially greater than typical for the visit (medical necessity must be documented)
`26`	Professional component	If distinguishing the professional component is required by payer (uncommon for `S9124`)
`51`	Multiple procedures	When multiple billable services are provided by the same visit and payer policy requires multiple-procedure reporting
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Generally not applicable, but included when payer-specific reporting requires it
`QX`	CRNA service with medical direction by physician	Not typical for LPN home care but included when specific modifier reporting by payers is required
`CO`	Repetitive services	When payer uses internal modifier coding to indicate repeated provision of care (payer-specific use)
`FX`	Service performed by LPN under RN supervision (payer-specific)	When payers require an explicit modifier to indicate LPN delivery under RN supervision
`QY`	Service furnished under a specific physician supervision level	When supervision level meets specific payer criteria for home health services
`SH`	Speech-language pathology services	Not directly applicable to `S9124` but included for multidisciplinary home visits where SLP services are also billed

Taxonomy Code	Specialty	Notes
`163W00000X`	Licensed Practical Nurse	Primary clinician billing or delivering the `S9124` service in the home
`163WC1500X`	Licensed Practical Nurse in Community Health	LPNs focused on community/home-based care; matches typical site of service
`251J00000X`	Home Health Agency	Organizational taxonomy for the agency employing the LPN and billing the service

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z74.01`	Bed confinement status	Indicates limited mobility; supports need for home nursing for prevention of complications and assistance with care
`Z48.89`	Encounter for other specified aftercare	Postoperative or procedure follow-up that may require skilled wound care and monitoring by an LPN in the home
`Z51.81`	Encounter for therapeutic drug level monitoring	Supports home nursing involvement for drawing labs, medication administration, and monitoring anticoagulant therapy
`Z79.01`	Long term (current) use of anticoagulants	Patients on chronic anticoagulation often require skilled monitoring and education provided during home nursing visits
`Z99.3`	Dependence on wheelchair	Mobility limitation that necessitates home-based nursing support for ADLs, prevention of pressure injuries, and medication management

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`S9123`	Nursing care, in the home; by registered nurse, per hour	RN-level counterpart to `S9124`; used when a registered nurse provides the hourly skilled visit instead of an LPN
`99503`	Home visit for respiratory therapy care	May be performed alongside `S9124` when the patient requires respiratory therapy support during the home nursing episode
`99504`	Home visit for mechanical ventilation care	Related when patients have complex ventilatory needs and coordinated nursing and respiratory services occur in the home
`99509`	Home visit for assistance with activities of daily living and personal care	Non-skilled or personal care services that may be coordinated with skilled nursing visits billed with `S9124`

HCPCS Level II S2152: Solid Organ Transplantation Global Care

HCPCS-LEVEL-II-S2266-INDUCED-ABORTION-29-TO-31-WEEKS

HCPCS Level II S2266: Induced Abortion, 29 to 31 Weeks

HCPCS-LEVEL-II-S3630-EOSINOPHIL-COUNT-BLOOD-DIRECT

HCPCS Level II S3630: Eosinophil Count, Blood, Direct

HCPCS-LEVEL-II-S4017-INCOMPLETE-ART-CYCLE-CANCELLED-PRIOR-TO-STIMULATION

HCPCS Level II S4017: Incomplete ART Cycle, Cancelled Prior to Stimulation

HCPCS-LEVEL-II-S8055-ULTRASOUND-GUIDANCE-MULTIFETAL-REDUCTION-TC

HCPCS Level II S8055: Ultrasound Guidance for Multifetal Pregnancy Reduction, Technical Component

HCPCS-LEVEL-II-S8940-EQUESTRIAN-HIPPOTHERAPY-PER-SESSION

HCPCS Level II S8940: Equestrian/Hippotherapy, Per Session

HCPCS-LEVEL-II-S9024-PARANASAL-SINUS-ULTRASOUND

HCPCS Level II S9024: Paranasal Sinus Ultrasound

HCPCS-LEVEL-II-S9366-HOME-TPN-1-2L-PER-DAY-HOME-INFUSION

HCPCS Level II S9366: Home TPN, 1–2 L/day, Per Diem

HCPCS-LEVEL-II-S9446-GROUP-PATIENT-EDUCATION-NON-PHYSICIAN

HCPCS Level II S9446: Group Patient Education by Non-Physician Provider

HCPCS-LEVEL-II-S9451-EXERCISE-CLASS-NON-PHYSICIAN-SESSION

HCPCS Level II S9451: Exercise Classes by Non-Physician Provider, Per Session

Showing 1–10 of 532

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`59`	Distinct procedural service	When a separately identifiable nursing service is provided on the same day as another service and must be distinguished
`52`	Reduced services	When the LPN performs a reduced or partially completed visit due to patient refusal or early termination
`53`	Discontinued procedure	When the visit is started but discontinued for patient safety or clinical reasons
`76`	Repeat procedure by same provider	When a nursing visit is repeated on the same day by the same provider for the same patient
`78`	Unplanned return to the same service/procedure during postoperative period	When an unplanned home nursing return visit is required for a postoperative complication within the global period
`22`	Increased procedural services	Rarely used; when care required is substantially greater than typical for the visit (medical necessity must be documented)
`26`	Professional component	If distinguishing the professional component is required by payer (uncommon for `S9124`)
`51`	Multiple procedures	When multiple billable services are provided by the same visit and payer policy requires multiple-procedure reporting
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Generally not applicable, but included when payer-specific reporting requires it
`QX`	CRNA service with medical direction by physician	Not typical for LPN home care but included when specific modifier reporting by payers is required
`CO`	Repetitive services	When payer uses internal modifier coding to indicate repeated provision of care (payer-specific use)
`FX`	Service performed by LPN under RN supervision (payer-specific)	When payers require an explicit modifier to indicate LPN delivery under RN supervision
`QY`	Service furnished under a specific physician supervision level	When supervision level meets specific payer criteria for home health services
`SH`	Speech-language pathology services	Not directly applicable to `S9124` but included for multidisciplinary home visits where SLP services are also billed

Taxonomy Code	Specialty	Notes
`163W00000X`	Licensed Practical Nurse	Primary clinician billing or delivering the `S9124` service in the home
`163WC1500X`	Licensed Practical Nurse in Community Health	LPNs focused on community/home-based care; matches typical site of service
`251J00000X`	Home Health Agency	Organizational taxonomy for the agency employing the LPN and billing the service

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z74.01`	Bed confinement status	Indicates limited mobility; supports need for home nursing for prevention of complications and assistance with care
`Z48.89`	Encounter for other specified aftercare	Postoperative or procedure follow-up that may require skilled wound care and monitoring by an LPN in the home
`Z51.81`	Encounter for therapeutic drug level monitoring	Supports home nursing involvement for drawing labs, medication administration, and monitoring anticoagulant therapy
`Z79.01`	Long term (current) use of anticoagulants	Patients on chronic anticoagulation often require skilled monitoring and education provided during home nursing visits
`Z99.3`	Dependence on wheelchair	Mobility limitation that necessitates home-based nursing support for ADLs, prevention of pressure injuries, and medication management

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`S9123`	Nursing care, in the home; by registered nurse, per hour	RN-level counterpart to `S9124`; used when a registered nurse provides the hourly skilled visit instead of an LPN
`99503`	Home visit for respiratory therapy care	May be performed alongside `S9124` when the patient requires respiratory therapy support during the home nursing episode
`99504`	Home visit for mechanical ventilation care	Related when patients have complex ventilatory needs and coordinated nursing and respiratory services occur in the home
`99509`	Home visit for assistance with activities of daily living and personal care	Non-skilled or personal care services that may be coordinated with skilled nursing visits billed with `S9124`

HCPCS Level II S2152: Solid Organ Transplantation Global Care

HCPCS-LEVEL-II-S2266-INDUCED-ABORTION-29-TO-31-WEEKS

HCPCS Level II S2266: Induced Abortion, 29 to 31 Weeks

HCPCS-LEVEL-II-S3630-EOSINOPHIL-COUNT-BLOOD-DIRECT

HCPCS Level II S3630: Eosinophil Count, Blood, Direct

HCPCS-LEVEL-II-S4017-INCOMPLETE-ART-CYCLE-CANCELLED-PRIOR-TO-STIMULATION

HCPCS Level II S4017: Incomplete ART Cycle, Cancelled Prior to Stimulation

HCPCS-LEVEL-II-S8055-ULTRASOUND-GUIDANCE-MULTIFETAL-REDUCTION-TC

HCPCS Level II S8055: Ultrasound Guidance for Multifetal Pregnancy Reduction, Technical Component

HCPCS-LEVEL-II-S8940-EQUESTRIAN-HIPPOTHERAPY-PER-SESSION

HCPCS Level II S8940: Equestrian/Hippotherapy, Per Session

HCPCS-LEVEL-II-S9024-PARANASAL-SINUS-ULTRASOUND

HCPCS Level II S9024: Paranasal Sinus Ultrasound

HCPCS-LEVEL-II-S9366-HOME-TPN-1-2L-PER-DAY-HOME-INFUSION

HCPCS Level II S9366: Home TPN, 1–2 L/day, Per Diem

HCPCS-LEVEL-II-S9446-GROUP-PATIENT-EDUCATION-NON-PHYSICIAN

HCPCS Level II S9446: Group Patient Education by Non-Physician Provider

HCPCS-LEVEL-II-S9451-EXERCISE-CLASS-NON-PHYSICIAN-SESSION

HCPCS Level II S9451: Exercise Classes by Non-Physician Provider, Per Session

Showing 1–10 of 532

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

HCPCS S9124: Nursing Care in Home by Licensed Practical Nurse, Hourly

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HCPCS S9124: Nursing Care in Home by Licensed Practical Nurse, Hourly

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Billing Code Overview

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

HCPCS S9124: Nursing Care in Home by Licensed Practical Nurse, Hourly

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Billing Code Overview

National Reimbursement Benchmarks

HCPCS S9124: Nursing Care in Home by Licensed Practical Nurse, Hourly

Sign up for hcpcs S9124 policy alerts

Billing Code Overview

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What service does HCPCS S9124 represent?

What are the typical reimbursement rates for S9124 across major commercial payers?

Which diagnoses and clinical situations commonly support billing S9124?

Which modifiers are commonly reported with S9124 and when are they used?

What other codes are related to S9124 and how do they differ?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What service does HCPCS S9124 represent?

What are the typical reimbursement rates for S9124 across major commercial payers?

Which diagnoses and clinical situations commonly support billing S9124?

Which modifiers are commonly reported with S9124 and when are they used?

What other codes are related to S9124 and how do they differ?

References