HCPCS S9213: Home Management of Preeclampsia, Per Diem

HCPCS Level II code S9213 represents a per-diem service for home management of preeclampsia, encompassing administrative support, professional pharmacy services, care coordination, and necessary supplies and equipment. It is intended to support outpatient management of pregnant patients with preeclampsia in the home setting, with drugs and nursing services reported separately. Nationally, this code is relevant as health systems expand home-based obstetric care and care coordination models aimed at reducing hospital utilization and supporting high-risk pregnancies.

Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the code's clinical intent and service setting, typical billing considerations tied to per-diem home management, and how payer coverage patterns may affect adoption. The publication also summarizes common modifiers and practical billing notes provided in the dataset, and offers context on where this code fits within home health and obstetric care delivery models.

The content is intended for billing managers, payers, and clinical program leads seeking concise guidance on what S9213 represents, which payers commonly cover similar services, and the operational context for deploying home-based management programs for preeclampsia. Data not available in the input is noted where applicable.

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Billing Code Overview

HCPCS Level II code S9213 describes home management of preeclampsia, billed on a per diem basis. The service includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment; drugs and nursing services are coded separately. The description indicates a home-based obstetric care coordination and support service focused on patients with preeclampsia.

Service Type: Home-based care / care coordination for preeclampsia

Typical Site of Service: Patient's home

Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and service line.

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HCPCS S9213: Home Management of Preeclampsia, Per Diem

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Get alerted when payer policies referencing S9213 are released or updated.

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Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

Service Type: Home-based care / care coordination for preeclampsia

Typical Site of Service: Patient's home

Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and service line.

Clinical & Coding Specifications

Clinical Context

A 32-year-old pregnant woman at 34 weeks' gestation is diagnosed with new-onset hypertension and proteinuria consistent with preeclampsia after outpatient evaluation. Her obstetrician determines that maternal and fetal conditions are stable but require close daily monitoring and medication management without inpatient admission. A home management service is arranged under S9213 to provide per diem administrative oversight, professional pharmacy coordination for antihypertensive therapy, care coordination between the obstetrician and home nursing, education on warning signs, and delivery/maintenance of necessary non-infused supplies and equipment. Nursing visits occur daily for blood pressure measurement, medication reconciliation, and symptom assessment; the obstetrician receives daily documentation and adjusts therapy as needed. Any drugs requiring infusion or separate nursing infusion services are billed separately and S9213 is not used with home infusion per diem codes. Typical workflow includes referral from the obstetric clinic, verification of eligibility and benefits with payors (e.g., Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, Medicare), enrollment, pharmacy coordination, initiation of daily skilled nursing visits, electronic transmission of vitals and urine/protein results to the provider, and documented multidisciplinary case reviews until resolution, delivery, or escalation to inpatient care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Data not available in the input.`	Preeclampsia with unspecified severity	Core diagnosis appropriate for home management under `S9213` when maternal and fetal status are stable and monitoring can be performed at home.
`Data not available in the input.`	Gestational hypertension without significant proteinuria	Frequently monitored in the home setting with antihypertensive therapy and close follow-up.
`Data not available in the input.`	Preeclampsia with severe features	May initially be managed at home only when features are controlled and close daily monitoring is in place; often necessitates rapid escalation if worsened.
`Data not available in the input.`	Chronic hypertension complicating pregnancy	Patients with preexisting hypertension requiring intensified home management and medication coordination.
`Data not available in the input.`	Superimposed preeclampsia on chronic hypertension	Indicates increased surveillance needs addressed via home management programs.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99201`	Office or other outpatient visit for the evaluation and management of a new patient, typically 10 minutes	May be used for initial obstetric evaluation that leads to enrollment in home management prior to `S9213` per diem services.
`99213`	Office or other outpatient visit for an established patient, typically 15 minutes	Commonly used for follow-up outpatient visits coordinating with home management and medication changes.
`99234`	Observation or inpatient hospital care including admission and discharge on the same date	Used if patient requires escalation from home management to observation or short inpatient stay; documents transition of care.
`99024`	Postoperative follow-up visit global surgical package excluded	Used when post-delivery follow-up occurs and is billed separately from home management per diem services.
`81002`	Urinalysis, non-automated, without microscopy	Performed as point-of-care testing in the home to assess proteinuria; billed separately from `S9213` when performed and reimbursable.
`99406`	Smoking and tobacco use cessation counseling intermediate, greater than 3 minutes up to 10 minutes	Example of an ancillary counseling CPT that may be provided by home nurses during visits; billed separately.

Related Modifiers

7 rows

Modifier	Description	When to Use
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
32	Modifier 32 (Mandated Services) indicates that a CPT-coded service was required by a third party—such as an insurer, school, state agency, or court. The AMA defines it as denoting services mandated…	- Use Modifier 32 when a service or procedure was explicitly mandated by a third party (for example an insurer requiring a second opinion, a school requiring a sports physical, a state agency or…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
76	Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…	- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
80	CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…	- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
385HR2050X	Respite Care Camp	A camping facility that provides specialized respite care to individuals requiring enhanced services to enable them to remain in the community, (e.g.,…
136A00000X	Registered Dietetic Technician	A Dietetic Technician, Registered (DTR)/Nutrition and Dietetics Technician, Registered (NDTR) is an individual holding a nationally protected title is…
323P00000X	Psychiatric Residential Treatment Facility	A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four ho…
261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	Ambulatory Health Care Facilities · Clinic/Center
106H00000X	Marriage & Family Therapist	A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related menta…
224P00000X	Prosthetist	A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained…
225200000X	Physical Therapy Assistant	(1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accred…
224L00000X	Pedorthist	An individual who is trained in the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, a…

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

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Data not available in the input.`	Preeclampsia with unspecified severity	Core diagnosis appropriate for home management under `S9213` when maternal and fetal status are stable and monitoring can be performed at home.
`Data not available in the input.`	Gestational hypertension without significant proteinuria	Frequently monitored in the home setting with antihypertensive therapy and close follow-up.
`Data not available in the input.`	Preeclampsia with severe features	May initially be managed at home only when features are controlled and close daily monitoring is in place; often necessitates rapid escalation if worsened.
`Data not available in the input.`	Chronic hypertension complicating pregnancy	Patients with preexisting hypertension requiring intensified home management and medication coordination.
`Data not available in the input.`	Superimposed preeclampsia on chronic hypertension	Indicates increased surveillance needs addressed via home management programs.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99201`	Office or other outpatient visit for the evaluation and management of a new patient, typically 10 minutes	May be used for initial obstetric evaluation that leads to enrollment in home management prior to `S9213` per diem services.
`99213`	Office or other outpatient visit for an established patient, typically 15 minutes	Commonly used for follow-up outpatient visits coordinating with home management and medication changes.
`99234`	Observation or inpatient hospital care including admission and discharge on the same date	Used if patient requires escalation from home management to observation or short inpatient stay; documents transition of care.
`99024`	Postoperative follow-up visit global surgical package excluded	Used when post-delivery follow-up occurs and is billed separately from home management per diem services.
`81002`	Urinalysis, non-automated, without microscopy	Performed as point-of-care testing in the home to assess proteinuria; billed separately from `S9213` when performed and reimbursable.
`99406`	Smoking and tobacco use cessation counseling intermediate, greater than 3 minutes up to 10 minutes	Example of an ancillary counseling CPT that may be provided by home nurses during visits; billed separately.

Related Modifiers

7 rows

Modifier	Description	When to Use
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
32	Modifier 32 (Mandated Services) indicates that a CPT-coded service was required by a third party—such as an insurer, school, state agency, or court. The AMA defines it as denoting services mandated…	- Use Modifier 32 when a service or procedure was explicitly mandated by a third party (for example an insurer requiring a second opinion, a school requiring a sports physical, a state agency or…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
76	Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…	- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
80	CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…	- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
385HR2050X	Respite Care Camp	A camping facility that provides specialized respite care to individuals requiring enhanced services to enable them to remain in the community, (e.g.,…
136A00000X	Registered Dietetic Technician	A Dietetic Technician, Registered (DTR)/Nutrition and Dietetics Technician, Registered (NDTR) is an individual holding a nationally protected title is…
323P00000X	Psychiatric Residential Treatment Facility	A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four ho…
261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	Ambulatory Health Care Facilities · Clinic/Center
106H00000X	Marriage & Family Therapist	A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related menta…
224P00000X	Prosthetist	A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained…
225200000X	Physical Therapy Assistant	(1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accred…
224L00000X	Pedorthist	An individual who is trained in the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, a…

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

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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 S9213: Home Management of Preeclampsia, Per Diem

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Billing Code Overview

OpenPayer

HCPCS S9213: Home Management of Preeclampsia, Per Diem

Sign up for hcpcs S9213 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Related Diagnoses

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related Diagnoses

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

References