CurrentPremera BluecrossPolicy N/A

Home birth kit supplies (HCPCS S8415)

Defines the Plan's limitations on supplies considered part of the Home Birth Kit (HCPCS S8415) for planned home births and how those supplies are billed on professional (CMS-1500 / 837P) claims. Applies to Premera Blue Cross lines of business and associated affiliates.

Policy Summary

PayerPremera Bluecross

PolicyHome birth kit supplies (HCPCS S8415)

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateMay 12, 2015

Next Review Date

Key ActionDo not submit separate reimbursement for individual supplies routinely included in a home birth kit; bill S8415 on professional claims (CMS-1500 / 837P).

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

S8415HCPCS code for supplies for home delivery of infant

1Submission limit per pregnancy (code S8415 limited to one submission per pregnancy)

Professional (CMS-1500 / 837P)Claim forms covered by this policy

Includes many routine suppliesExamples of supplies considered part of the kit (non-exhaustive)

Mother onlyS8415 should be submitted for

Coverage Criteria

Coverage criteria for S8415

Routine supplies used during a planned home birth are considered included in the home birth kit (HCPCS S8415) and are not separately reimbursable.

ALL of the following

Examples (non-exhaustive)
- Adult mask and oral airway
- Fetoscope and/or doppler device
- Oxygen tank, tubing, and flow meters
- Oxygen saturation monitor

Policy Summary

PayerPremera Bluecross

PolicyHome birth kit supplies (HCPCS S8415)

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateMay 12, 2015

Next Review Date

Key ActionDo not submit separate reimbursement for individual supplies routinely included in a home birth kit; bill S8415 on professional claims (CMS-1500 / 837P).

SourceLink

On This Page

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.

Neonatal resuscitation mask

Portable light source

Portable oral suction device(s) for infant

Sterile birth instruments and instruments for episiotomy and repair

Stethoscope and blood pressure cuff

Tape measure, timepiece and thermometer

IV set-up supplies and administration

Venipuncture supplies

Urinalysis supplies (catch cups, dipsticks)

Injection supplies for mother and baby

Neonatal ophthalmic ointment (eye prophylaxis)

Sterile supplies and sterile gloves

Cord clamps, binding equipment or umbilical tape

Cord blood collection supplies

Cleaning/antimicrobial solutions (e.g., rubbing alcohol)

Suture supplies and local anesthesia for perineal repair

Supplies to wrap and dispose of placenta

Sharps and disposal container

Related IV solution drugs and medications (e.g., magnesium sulfate, methergine, oxytocin/Pitocin, vitamin K, adrenaline/epinephrine, normal saline, Ringer's lactate, dextrose in lactated ringers)

Appropriate device for measuring newborn's blood sugar values

S8415 should be billed on the mother's professional claim (CMS-1500 / 837P).

S8415 is limited to one submission per pregnancy and should be submitted for the mother only.

Submission limit: one submission per pregnancy.

Coverage is subject to member eligibility, benefit limits, and claims adjudication edits; reimbursement is restricted to the provider's applicable billing rules.

Coding

Home birth kit codeHCPCSCovered

S8415

Supplies for home delivery of infant

Submission limit

Submission limitCode S8415 is limited to one submission per pregnancy.

Patient for submissionS8415 should be submitted for the mother only.

Claim formBill S8415 on the mother's professional claim (CMS-1500 / 837P).

Provider Billing Actions

Billing Rule

Bill S8415 for bundled home-birth supplies (no separate supply reimbursement)

Do not submit separate reimbursement for individual supplies routinely included in a home birth kit; bill HCPCS code S8415 (Supplies for home delivery of an infant) on professional claims (CMS-1500 / 837P). Code S8415 is limited to one submission per pregnancy and should be submitted for the mother only.

Bill S8415 on the mother's professional claim (CMS-1500 / 837P).
Do not separately bill individual routine supplies listed as part of the home birth kit.

Definitions

Home Birth Kit

TermHome Birth Kit: A portable kit transported to and from a home birth delivery that contains disposable and non-disposable supplies/equipment used by the birthing provider during the delivery process.

Included supplies (examples)Adult mask and oral airway; fetoscope and/or Doppler device; oxygen tank, tubing, and flow meters; oxygen saturation monitor; neonatal resuscitation mask; portable light source; neonatal ophthalmic ointment; sterile supplies and gloves; cord clamps; suture supplies; infant bulb syringe.

Reimbursement ruleIndividual supplies routinely used during a planned home birth are considered included in the home birth kit (HCPCS S8415) and are not separately reimbursable.

Planned Home Birth

DefinitionPlanned Home Birth: A natural birth that occurs in the home usually attended by a licensed midwife, a certified nurse midwife/advanced registered nurse practitioner (ARNP) or a physician.

ScopeApplies to planned home births rendered in the patient's home setting.

Coverage implicationSupplies used during a planned home birth are considered part of the Home Birth Kit and are not separately reimbursable; coverage is subject to member eligibility, benefit limits, and claims adjudication edits.