Summary & Overview
HCPCS Level II S9124: Nursing care, in the home; by licensed practical nurse, per hour
Headline: HCPCS Level II code S9124: Hourly Licensed Practical Nurse Care Delivered in the Home
Lead: HCPCS Level II code S9124 designates in-home nursing care provided by a licensed practical nurse (LPN), billed on an hourly basis. The code captures routine and skilled LPN services delivered at a patient’s residence and is used across private payers and managed-care plans to document home-based nursing support.
What the code represents and why it matters nationally: S9124 identifies LPN-delivered nursing services provided in the home, an increasingly important component of community-based care as payers and providers shift services from institutional to home settings. Accurate use of this code affects claims adjudication, care planning documentation, and aggregation of utilization data for home health services.
Key payers covered: Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare.
Overview of what readers will learn: This publication explains the clinical context for S9124, its role within home-based nursing services, common related service lines, and typical sites of service. Readers will find guidance on typical billing scenarios, common accompanying service codes, and considerations for coding consistency and documentation. Where input data are incomplete, the report notes missing elements explicitly (for example: Data not available in the input). The content targets clinicians, coding professionals, and policy analysts seeking a concise reference on how hourly LPN home care is classified and reported in administrative claims.
Billing Code Overview
HCPCS Level II code S9124 describes nursing care in the home provided by a licensed practical nurse, billed per hour. This service falls under Miscellaneous Supplies and Services and is typically furnished in the home (Place of Service 12). The code denotes one-on-one nursing care delivered in a patient’s residence and is used to document and bill hourly licensed practical nurse services in the home setting.
Clinical & Coding Specifications
Clinical Context
A homebound adult patient with limited mobility and ongoing nursing needs receives hourly licensed practical nurse (LPN) visits for skilled nursing tasks. Typical reasons include wound care, medication administration or monitoring (including therapeutic drug level checks), assistance with activities of daily living related to bed confinement or wheelchair dependence, and transitional aftercare following hospital discharge. The LPN documents visit start and stop times, tasks performed (e.g., medication administration, vital signs, skin/wound assessment), communication with the supervising provider or home health agency, and any changes in patient status that require escalation to a registered nurse or physician. Services are delivered in the patient’s residence (Place of Service 12).
Coding Specifications
-
Modifier
TT: Use when an individualized service is provided to more than one patient in the same setting. Apply to indicate that the billed unit reflects that circumstance. -
Modifier
59: Use to indicate a Distinct Procedural Service when a separately identifiable service or procedure is performed in addition to another service on the same day. -
Associated provider taxonomies and specialties:
| Taxonomy code |
|---|