HCPCS Level II S9346: Home Infusion Alpha-1-Proteinase Inhibitor Administrative Services

HCPCS Level II code S9346 describes a per diem administrative and professional pharmacy service for home infusion therapy with alpha-1-proteinase inhibitor (e.g., prolastin), covering care coordination and necessary supplies and equipment while the actual drug and nursing visits are coded separately; typical service type is home infusion care coordination and pharmacy administrative services, and the typical site of service is patient residence/home.

For related coverage guidance, see recent payer policy updates: Fixed Wing Air Ambulance Transport, Air Ambulance, Ambulance Services (for Tennessee Only).

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Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with confirmed alpha-1 antitrypsin deficiency and clinically significant emphysema who requires weekly home infusion of alpha-1-proteinase inhibitor (A1PI) replacement therapy. The patient is referred by a pulmonologist following genotyping and pulmonary function testing that demonstrate accelerated decline in FEV1 and radiographic/emphysematous changes. A home infusion pharmacy coordinates logistics, obtains prior authorization from payors (for example, Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare), schedules a licensed infusion nurse, supplies infusion equipment and disposables, and documents each per-diem administrative service under S9346. The actual drug product (e.g., Prolastin) is billed separately by NDC or J-code, nursing visits are billed with appropriate home health or infusion visit CPT/HCPCS codes, and any laboratory monitoring (alpha-1 levels, infectious disease screening) is ordered by the clinician and billed separately.

Typical workflow:

Referral and prior authorization initiated by the pulmonologist.
Home infusion pharmacy verifies diagnosis, establishes plan of care, and coordinates nursing visits and infusion schedule.
Pharmacy delivers A1PI drug (billed separately), disposables, infusion pump if required, and documents per-diem administrative services under S9346 for care coordination, professional pharmacy services, and supplies/equipment (excluding drug and nursing visit charges).
Licensed nurse performs home infusion visits, monitors for infusion reactions, documents vitals and adverse events, and communicates with the ordering clinician.
Ongoing monitoring includes pulmonary follow-up, periodic pulmonary function tests, and insurance reauthorization as required.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Used for routine outpatient follow-up visits by the ordering clinician to assess therapy response and authorization documentation.
`96365`	Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour	Used when a nursing visit provides the active intravenous infusion of A1PI (if billed separately for nursing infusion time).
`99406`	Smoking and tobacco use cessation counseling visit, intermediate, greater than 3 minutes up to 10 minutes	Often performed in pulmonary patients; billed separately when provided as part of counseling during follow-up.
`36415`	Collection of venous blood by venipuncture	Used when blood is drawn for laboratory monitoring related to therapy (e.g., serology, baseline labs).

Related Modifiers

6 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
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…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207RH0000X	Hematology (Internal Medicine) Physician	An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
333600000X	Pharmacy	A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative servi…
363A00000X	Physician Assistant	A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
246QL0900X	Laboratory Management Specialist/Technologist	Technologists, Technicians & Other Technical Service Providers · Specialist/Technologist, Pathology
2080P0216X	Pediatric Rheumatology Physician	A pediatrician who treats diseases of joints, muscle, bones and tendons. A pediatric rheumatologist diagnoses and treats arthritis, back pain, muscle …
111NN1001X	Nutrition Chiropractor	Chiropractic Nutrition is that specialty within the chiropractic profession that deals with the overall factors that affect the patient's ability to m…
261QL0400X	Lithotripsy Clinic/Center	Ambulatory Health Care Facilities · Clinic/Center
2084A2900X	Neurocritical Care Physician	The medical subspecialty of Neurocritical Care is devoted to the comprehensive, multisystem care of the critically-ill neurological patient. Like othe…

Related ICD-10-CM Codes

29 rows

ICD-10-CM Code	Description
D80.9	Immunodeficiency with predominantly antibody defects, unspecified
D83.9	Common variable immunodeficiency, unspecified
D89.9	Disorder involving the immune mechanism, unspecified
E84.9	Cystic fibrosis, unspecified
E88.01	Alpha-1-antitrypsin deficiency
I50.9	Heart failure, unspecified
J43.1	Panlobular emphysema
J43.9	Emphysema, unspecified
J44.0	Chronic obstructive pulmonary disease with (acute) lower respiratory infection
J44.9	Chronic obstructive pulmonary disease, unspecified

Showing 1–10 of 29

Related Payer Policy Updates

Specialty: Emergency & Medical Transportation1 / 3

9 rows

Policy	Payer	Effective Date
Fixed Wing Air Ambulance Transport	Cigna	2026-08-15
Air Ambulance	Ambetter Georgia	2026-08-01
Ambulance Services (for Tennessee Only)	UnitedHealthcare	2026-08-01
Ambulance Services (for New Mexico Only)	UnitedHealthcare	2026-08-01
Clinical Policy: Air Ambulance	Arizona Complete Health	2026-08-01
Clinical Policy: Air Ambulance	Centene	2026-08-01
Air Ambulance	Centene	2026-08-01
Clinical Policy: Air Ambulance	Ambetter Nevada	2026-08-01
Ambulance Transport	Providence Health Plan	2026-07-01

HCPCS Level II S2152: Solid Organ Procurement and Transplantation

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 Cycle — Cancelled Prior to Stimulation

HCPCS-LEVEL-II-S8055-ULTRASOUND-GUIDANCE-MULTIFETAL-REDUCTION-TC

HCPCS Level II S8055: Ultrasound Guidance for Multifetal Pregnancy Reduction

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 Infusion TPN, 1–2 L/day

HCPCS-LEVEL-II-S9446-GROUP-PATIENT-EDUCATION-NON-PHYSICIAN

HCPCS S9446: Patient Education, Non-Physician Provider, Group, Per Session

HCPCS-LEVEL-II-S9451-EXERCISE-CLASS-NON-PHYSICIAN-SESSION

HCPCS S9451: Exercise Classes, Non-Physician Provider, Per Session

Showing 1–10 of 532

Frequently Asked Questions

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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Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Typical workflow:

Referral and prior authorization initiated by the pulmonologist.
Home infusion pharmacy verifies diagnosis, establishes plan of care, and coordinates nursing visits and infusion schedule.
Pharmacy delivers A1PI drug (billed separately), disposables, infusion pump if required, and documents per-diem administrative services under S9346 for care coordination, professional pharmacy services, and supplies/equipment (excluding drug and nursing visit charges).
Licensed nurse performs home infusion visits, monitors for infusion reactions, documents vitals and adverse events, and communicates with the ordering clinician.
Ongoing monitoring includes pulmonary follow-up, periodic pulmonary function tests, and insurance reauthorization as required.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Used for routine outpatient follow-up visits by the ordering clinician to assess therapy response and authorization documentation.
`96365`	Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour	Used when a nursing visit provides the active intravenous infusion of A1PI (if billed separately for nursing infusion time).
`99406`	Smoking and tobacco use cessation counseling visit, intermediate, greater than 3 minutes up to 10 minutes	Often performed in pulmonary patients; billed separately when provided as part of counseling during follow-up.
`36415`	Collection of venous blood by venipuncture	Used when blood is drawn for laboratory monitoring related to therapy (e.g., serology, baseline labs).

Related Modifiers

6 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
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…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207RH0000X	Hematology (Internal Medicine) Physician	An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
333600000X	Pharmacy	A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative servi…
363A00000X	Physician Assistant	A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
246QL0900X	Laboratory Management Specialist/Technologist	Technologists, Technicians & Other Technical Service Providers · Specialist/Technologist, Pathology
2080P0216X	Pediatric Rheumatology Physician	A pediatrician who treats diseases of joints, muscle, bones and tendons. A pediatric rheumatologist diagnoses and treats arthritis, back pain, muscle …
111NN1001X	Nutrition Chiropractor	Chiropractic Nutrition is that specialty within the chiropractic profession that deals with the overall factors that affect the patient's ability to m…
261QL0400X	Lithotripsy Clinic/Center	Ambulatory Health Care Facilities · Clinic/Center
2084A2900X	Neurocritical Care Physician	The medical subspecialty of Neurocritical Care is devoted to the comprehensive, multisystem care of the critically-ill neurological patient. Like othe…

Related ICD-10-CM Codes

29 rows

ICD-10-CM Code	Description
D80.9	Immunodeficiency with predominantly antibody defects, unspecified
D83.9	Common variable immunodeficiency, unspecified
D89.9	Disorder involving the immune mechanism, unspecified
E84.9	Cystic fibrosis, unspecified
E88.01	Alpha-1-antitrypsin deficiency
I50.9	Heart failure, unspecified
J43.1	Panlobular emphysema
J43.9	Emphysema, unspecified
J44.0	Chronic obstructive pulmonary disease with (acute) lower respiratory infection
J44.9	Chronic obstructive pulmonary disease, unspecified

Showing 1–10 of 29

Related Payer Policy Updates

Specialty: Emergency & Medical Transportation1 / 3

9 rows

Policy	Payer	Effective Date
Fixed Wing Air Ambulance Transport	Cigna	2026-08-15
Air Ambulance	Ambetter Georgia	2026-08-01
Ambulance Services (for Tennessee Only)	UnitedHealthcare	2026-08-01
Ambulance Services (for New Mexico Only)	UnitedHealthcare	2026-08-01
Clinical Policy: Air Ambulance	Arizona Complete Health	2026-08-01
Clinical Policy: Air Ambulance	Centene	2026-08-01
Air Ambulance	Centene	2026-08-01
Clinical Policy: Air Ambulance	Ambetter Nevada	2026-08-01
Ambulance Transport	Providence Health Plan	2026-07-01

HCPCS Level II S2152: Solid Organ Procurement and Transplantation

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 Cycle — Cancelled Prior to Stimulation

HCPCS-LEVEL-II-S8055-ULTRASOUND-GUIDANCE-MULTIFETAL-REDUCTION-TC

HCPCS Level II S8055: Ultrasound Guidance for Multifetal Pregnancy Reduction

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 Infusion TPN, 1–2 L/day

HCPCS-LEVEL-II-S9446-GROUP-PATIENT-EDUCATION-NON-PHYSICIAN

HCPCS S9446: Patient Education, Non-Physician Provider, Group, Per Session

HCPCS-LEVEL-II-S9451-EXERCISE-CLASS-NON-PHYSICIAN-SESSION

HCPCS S9451: Exercise Classes, Non-Physician Provider, Per Session

Showing 1–10 of 532

Frequently Asked Questions

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.

HCPCS Level II S9346: Home Infusion Alpha-1-Proteinase Inhibitor Administrative Services

Sign up for hcpcs S9346 policy alerts

HCPCS Level II S9346: Home Infusion Alpha-1-Proteinase Inhibitor Administrative Services

Sign up for hcpcs S9346 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

HCPCS Level II S9346: Home Infusion Alpha-1-Proteinase Inhibitor Administrative Services

Sign up for hcpcs S9346 policy alerts

HCPCS Level II S9346: Home Infusion Alpha-1-Proteinase Inhibitor Administrative Services

Sign up for hcpcs S9346 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What services does HCPCS code S9346 represent and what is excluded?

How is care coordinated and billed when using S9346 for alpha-1 therapy?

Which modifiers are commonly used with S9346 and when are they applied?

What other CPT/HCPCS and procedure codes commonly appear on claims with S9346?

What diagnoses and payers are relevant when billing S9346?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What services does HCPCS code S9346 represent and what is excluded?

How is care coordinated and billed when using S9346 for alpha-1 therapy?

Which modifiers are commonly used with S9346 and when are they applied?

What other CPT/HCPCS and procedure codes commonly appear on claims with S9346?

What diagnoses and payers are relevant when billing S9346?

References