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    v1.0.28
    OpenPayerBilling CodesTemporary National Codes (Non-Medicare)HCPCS hcpcs-s9460-diabetic-management-nurse-visit
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    HCPCS S9460: Diabetic Management Program, Nurse Visit

    HCPCS Level II code S9460 denotes a diabetic management program, nurse visit, representing nursing-led diabetes education and disease management services provided as part of a structured program; typical service type is diabetes care and education and the usual site of service is outpatient clinic or home health visit depending on program delivery.

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

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a middle-aged adult with type 2 diabetes mellitus attending a diabetic management program nurse visit billed with S9460. The patient presents to an outpatient clinic or community health center for scheduled follow-up focusing on diabetes self-management. The nurse reviews home glucose logs, assesses medication adherence, checks vital signs including weight and blood pressure, performs foot inspection, provides diabetes education (diet, glucose monitoring, lifestyle), and adjusts counseling based on recent hemoglobin A1c results. Basic point-of-care testing such as capillary blood glucose may be performed; venipuncture for laboratory testing (for example, hemoglobin A1c) is arranged if indicated. The encounter is typically documented in the outpatient clinic chart; the nurse documents education provided, self-management goals set, referrals (diabetes educator, nutritionist, podiatry) and communicates recommendations to the primary care provider or supervising clinician. This procedure commonly occurs in ambulatory clinic exam rooms, community health centers, patient homes under home health programs, and federally qualified health centers. Typical visit length ranges from 15 to 45 minutes depending on complexity and education needs. Follow-up scheduling is based on glycemic control and comorbid conditions.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99213Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutesMay be used by supervising clinicians when a physician or qualified non-physician provider documents an E/M visit related to diabetes management following the nurse visit.
    82947Glucose; quantitative, blood (except reagent strip)Common lab test ordered or performed near the nurse visit to assess glycemic control.
    83036Hemoglobin; glycosylated (A1c)Often ordered as part of diabetes management to assess medium-term glycemic control and guide education and therapy.
    99078Physician or other qualified health care professional services in a group setting; patient educationUsed for structured diabetes education sessions that complement individual nurse visits.
    95250Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; retrospective CGM analysis and interpretationMay be ordered as an adjunctive diagnostic tool when intensive glucose monitoring is indicated following issues identified in the nurse visit.

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    22Modifier –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…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑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…
    53Modifier 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…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    95Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim…- Use modifier 95 to indicate a service was furnished via synchronous, real‑time audiovisual telehealth (a live audio‑video conference between patient and provider) rather than in‑person. - Pair…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207RC0000XCardiovascular Disease PhysicianAn internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threaten…
    207QA0505XAdult Medicine PhysicianThe NUCC recommends this code not be used. Choose a more appropriate code.
    207R00000XInternal Medicine PhysicianA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
    2080T0004XPediatric Transplant Hepatology PhysicianA pediatrician with expertise in transplant hepatology encompasses the special knowledge and skill required of pediatric gastroenterologists to care f…
    287300000XDeactivated - Christian Science SanitoriumInactive, use 282J00000X
    193200000XMulti-Specialty GroupA business group of one or more individual practitioners, who practice with different areas of specialization.
    364SM0705XMedical-Surgical Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
    207ZI0100XImmunopathology PhysicianA pathologist who specializes in the diagnosis of immunologic diseases.

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    E08.9Diabetes mellitus due to underlying condition without complications
    E10.21Type 1 diabetes mellitus with diabetic nephropathy
    E10.29Type 1 diabetes mellitus with other diabetic kidney complication
    E10.51Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene
    E10.621Type 1 diabetes mellitus with foot ulcer
    E10.65Type 1 diabetes mellitus with hyperglycemia
    E10.9Type 1 diabetes mellitus without complications
    E11.21Type 2 diabetes mellitus with diabetic nephropathy
    E11.22Type 2 diabetes mellitus with diabetic chronic kidney disease
    E11.29Type 2 diabetes mellitus with other diabetic kidney complication

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: Emergency & Medical Transportation1 / 3

    10 rows

    PolicyPayerEffective Date
    Fixed Wing Air Ambulance TransportCigna2026-08-15
    Air AmbulanceAmbetter Georgia2026-08-01
    Ambulance Services (for New Mexico Only)UnitedHealthcare2026-08-01
    Ambulance Services (for Tennessee Only)UnitedHealthcare2026-08-01
    Clinical Policy: Air AmbulanceArizona Complete Health2026-08-01
    Air AmbulanceCentene2026-08-01
    Clinical Policy: Air AmbulanceCentene2026-08-01
    Clinical Policy: Air AmbulanceAmbetter Nevada2026-08-01
    Ambulance TransportProvidence Health Plan2026-07-01
    Air ambulance transport coverage criteriaeocco2026-07-01

    Related Codes

    HCPCS-LEVEL-II-S2152-SOLID-ORGAN-TRANSPLANTATION-GLOBAL-CARE

    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

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    Frequently Asked Questions

    References

    1. 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. 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. 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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