Summary & Overview

HCPCS S9140: Diabetic Management Program Follow-Up Visit, Non-MD

HCPCS Level II code S9140 denotes a diabetic management program follow-up visit delivered by a non-physician provider. This code captures ongoing, non-MD encounters focused on diabetes self-management education, monitoring, and coordination of care — services that support chronic disease control and potentially reduce acute complications. Its use reflects the growing role of allied health professionals and care teams in chronic disease management nationwide.

Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The code is relevant across commercial and public payers that recognize non-MD delivered chronic care services.

Readers will learn what S9140 represents clinically and administratively, which payers accept or reference the code (where available), and how the code functions within service lines for ambulatory and community-based diabetes care. The analysis also covers common modifiers, typical sites of service, and contexts where this code is applied. Where input data is incomplete, the publication flags missing elements such as associated taxonomies, specific ICD-10 pairings, and payer-specific coverage nuances. The content is intended for billing managers, compliance officers, and clinical program leads who manage diabetes care workflows and coding practices nationally.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareS9140HCPCS Level IIdiabetes managementchronic disease managementnon-physician servicesoutpatient carepatient educationcare coordination

Billing Code Overview

HCPCS Level II code S9140 represents a diabetic management program follow-up visit provided by a non-MD clinician. The service is a follow-up component of ongoing diabetes management, focusing on patient education, monitoring of glycemic control, medication adherence, lifestyle counseling, and care coordination as delivered by qualified non-physician providers.

Service type: Diabetic management follow-up visit with a non-physician provider
Typical site of service: Ambulatory clinic, outpatient clinic, or community-based care settings where non-MD providers deliver diabetes follow-up care

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 58-year-old patient with type 2 diabetes mellitus attends a scheduled follow-up visit in a diabetic management program delivered by a non-physician provider (for example, a certified diabetes educator or registered nurse). The patient was referred after initial diagnosis and education and is now seen to review self-monitoring blood glucose logs, reinforce diet and medication adherence, assess injection technique, review home glucose meter downloads, adjust lifestyle goals, and plan follow-up. The visit includes medication reconciliation (no new prescriptions initiated by the non‑MD provider), evaluation of recent glycemic control, targeted foot and skin inspection, brief counseling on hypoglycemia prevention, and documentation of an updated personalized care plan. Typical workflow: pre-visit chart review, brief vitals and fingerstick glucose by nursing assistant, focused education and counseling by the diabetes educator, documentation of findings and care plan in the medical record, communication of assessment to the supervising physician as required by local supervision rules, and scheduling of the next follow-up or referral for medication management if needed.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When billing for the professional component of a split-service if applicable (rare for this code).
`59`	Distinct procedural service	When a separately identifiable, distinct service unrelated to the diabetic management visit is performed the same day.
`76`	Repeat procedure or service by same provider	When the same service is repeated later the same day by the same provider.
`77`	Repeat procedure by another provider	When the same service is repeated by a different provider the same day.
`52`	Reduced services	When the service provided is partially reduced or not completed as originally described.
`53`	Discontinued procedure	When the service was started but discontinued due to patient instability or other acceptable reason.
`22`	Increased procedural services	When the visit required substantially greater work than typically required (document justification).
`51`	Multiple procedures	When reporting multiple distinct services/procedures on the same day (use when payer requires).
`62`	Two surgeons	If two qualified practitioners share responsibility for the service (rare for this code).
`76`	Repeat procedure or service by same provider	When the same service is repeated later the same day by the same provider.

Taxonomy Code	Specialty	Notes
`163W00000X`	Certified Diabetes Educator	Primary non-physician provider for diabetes education and management follow-up.
`164W00000X`	Registered Nurse	Common provider for follow-up visits focusing on self-management and monitoring.
`163G00000X`	Clinical Nurse Specialist (Endocrinology)	Provides disease-specific education and program oversight.
`207Q00000X`	Family Medicine	Supervising or coordinating physician commonly associated with the program.
`207L00000X`	Internal Medicine	Supervising physician specialty often involved with diabetes care plans.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`E11.9`	Type 2 diabetes mellitus without complications	Common primary diagnosis for enrollment in a diabetic management follow-up program to monitor glycemic control and self-care.
`E11.65`	Type 2 diabetes mellitus with hyperglycemia	Relevant when the follow-up visit addresses recent elevated glucose readings and adjustment of the care plan.
`E11.69`	Type 2 diabetes mellitus with other specified complications	Used when the visit addresses complications such as neuropathy or skin issues needing education and care planning.
`E11.21`	Type 2 diabetes mellitus with diabetic nephropathy	Relevant when the follow-up includes monitoring related to kidney disease and coordination of management.
`E10.9`	Type 1 diabetes mellitus without complications	Included when the program provides education and follow-up for type 1 patients managed by non‑MD providers.
`R73.9`	Hyperglycemia, unspecified	Used when abnormal glucose levels are the focus of the follow-up visit pending definitive diabetes classification or adjustment.
`Z71.3`	Dietary counseling and surveillance	Captures the counseling component of the diabetes management visit concerning nutrition and lifestyle.
`Z79.4`	Long term (current) use of insulin	Relevant when the follow-up involves insulin technique review, adherence, and education.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99211`	Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician (typically 5 minutes)	Often used for brief nurse-led follow-up visits or ancillary visits accompanying diabetes education when a billing-level E/M is required.
`98960`	Education and training for patient self-management by qualified non-physician provider, face-to-face; individual, 30 minutes	Commonly billed for structured diabetes self-management education sessions provided by a qualified non‑MD provider.
`83036`	Hemoglobin; glycosylated (A1c)	Performed or ordered as part of diabetes follow-up to assess glycemic control; may be performed before or after the visit.
`82947`	Glucose; quantitative, blood (single test)	Point-of-care fingerstick glucose checks often performed during the visit to guide counseling.
`95250`	Ambulatory continuous glucose monitoring of interstitial tissue glucose, with sensor placement and data download/interpretation, initial; 1 sensor	Used when initiating CGM as part of management; education and follow-up coordination occur in the diabetes program.
`99406`	Smoking and tobacco use cessation counseling visit, intermediate, greater than 3 minutes up to 10 minutes	Counseling for tobacco cessation provided during diabetes education and documented separately when time-based.