Summary & Overview
HCPCS S9345: Home Infusion Anti-Hemophilic Agent Administrative Services
HCPCS Level II code S9345 denotes a per diem administrative and professional pharmacy service bundle for home infusion of anti-hemophilic agents (for example, factor VIII). The code captures non-drug components necessary to support home-based infusion therapy, including care coordination, pharmacy management, and supplies and equipment; the actual drug product and nursing visits are billed separately. This code matters nationally as home infusion expands for chronic bleeding disorders, shifting care from hospital and clinic settings to patients’ homes and affecting utilization, reimbursement, and care coordination pathways.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical service and site of care, national implications for home-based hemophilia management, and the types of benchmarks and policy considerations typically associated with per diem administrative billing for infusion therapies. The publication outlines where S9345 fits in clinical workflows, which components are bundled versus billed separately, common modifiers seen in practice, and guidance on items typically expected to accompany this code. Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, related codes, and payer-specific rates.
Billing Code Overview
HCPCS Level II code S9345 describes home infusion therapy for anti-hemophilic agent infusion (for example, factor VIII) and covers administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately) on a per diem basis.
Service type: Home infusion administration services and care coordination for anti-hemophilic therapy.
Typical site of service: Patient's home (home infusion setting).
Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult or pediatric individual with moderate to severe hemophilia A requiring regular anti-hemophilic factor VIII replacement delivered at home. The patient or caregiver receives training from a home infusion nurse on peripheral IV or venous access device use, infusion administration, aseptic technique, and infusion logs. Healthcare team coordination includes the prescribing hematologist, specialty pharmacy arranging factor concentrate delivery, home infusion nursing for IV access and observation, and case management for authorization and supply logistics. The per diem service covers administrative services, professional pharmacy services, care coordination, and supplies/equipment related to home infusion therapy while the actual drug product (factor concentrate) and nursing visits are billed separately. Typical workflow: prescription and order entry by the hematology clinic; prior authorization and shipment by the specialty pharmacy; scheduling of home infusion nursing and initial home visit for training; ongoing per diem administrative and coordination activities with periodic clinical follow-up and documentation of infusion outcomes.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Use when no specific modifier applies to the claim |
22 |