Summary & Overview
HCPCS S9340: Home Enteral Nutrition Administrative and Pharmacy Services
HCPCS Level II code S9340 identifies per diem administrative services for home-based enteral nutrition, including professional pharmacy services, care coordination, and all necessary supplies and equipment (with enteral formula and nursing visits billed separately). This code matters nationally as home enteral nutrition is an essential chronic-care service that involves multidisciplinary coordination and supply management; clear coding supports appropriate payment for non-clinical, administrative elements of home nutrition therapy. Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find an overview of the service the code represents, guidance on expected site of service and service type, and a framework for understanding where S9340 fits within home infusion and enteral nutrition billing. The publication provides benchmarking context and policy-relevant considerations for payers and plan administrators, explains which components are bundled versus billed separately (noting enteral formula and nursing visits are excluded from this per diem), and highlights common modifiers used with this code. Data not available in the input on specific payer rates, taxonomies, ICD-10 pairings, and related codes is noted.
Billing Code Overview
HCPCS Level II code S9340 describes home therapy administrative services associated with enteral nutrition provided on a per diem basis. The code covers professional pharmacy services, care coordination, and all necessary supplies and equipment related to enteral nutrition, while the enteral formula and nursing visits are billed separately.
Service type: Home-based enteral nutrition administrative and support services
Typical site of service: Patient's home (home health/home infusion setting)
Data not available in the input for payers, associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A typical patient is a medically complex adult or pediatric patient who requires ongoing enteral nutrition delivered at home via a gastrostomy or nasogastric tube after hospital discharge. The home infusion or home health agency provides per diem administrative services including professional pharmacy oversight, care coordination, and supply management while enteral formula and skilled nursing visits are billed separately. A common scenario: a patient with chronic neurologic impairment and dysphagia is discharged following stabilization of aspiration risk; the discharge planner arranges a home enteral nutrition program. The pharmacy performs medication and formula reconciliation, trains caregivers on tube care and feeding pump use, coordinates durable medical equipment delivery (feeding pumps, extension sets), and schedules nursing follow-up. Clinical workflow steps include: hospital discharge planning and prescription for home enteral therapy, prior authorization and insurance verification, pharmacy intake and assessment, delivery of supplies and equipment to the home, caregiver education and demonstration, telephonic or in-person nursing follow-up, and ongoing care coordination for formula changes or complications such as tube blockage or site infection.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the professional component of a separately billable service related to enteral therapy (e.g., pharmacist clinical consultation billed separately). |