S9475 — Ambulatory setting substance abuse treatment or detoxification services, per diem
S9475 is a HCPCS Level II code for ambulatory setting substance abuse treatment or detoxification services, per diem. It belongs to the Temporary National Codes (Non-Medicare) section. Medicare does not pay it — see the coverage note below before you bill it.
Medicare coverage: Not payable by Medicare
Medicare does not pay this code. It may still be valid for another payer, but a Medicare claim carrying it will not be reimbursed.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusI
Not valid for Medicare purposes. Medicare uses another code.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
The CMS record for S9475
- Long descriptor
- Ambulatory setting substance abuse treatment or detoxification services, per diem
- Short descriptor
- Ambulatory setting substance
- Added
- January 1, 2000
- BETOS
- Z2
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to S9475
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If S9475 is not quite right, the correct code is very often within a few positions of it.
- S9454Stress management classes, non-physician provider, per session
- S9455Diabetic management program, group session
- S9460Diabetic management program, nurse visit
- S9465Diabetic management program, dietitian visit
- S9470Nutritional counseling, dietitian visit
- S9472Cardiac rehabilitation program, non-physician provider, per diem
- S9473Pulmonary rehabilitation program, non-physician provider, per diem
- S9474Enterostomal therapy by a registered nurse certified in enterostomal therapy, per diem
- S9476Vestibular rehabilitation program, non-physician provider, per diem
- S9480Intensive outpatient psychiatric services, per diem
- S9482Family stabilization services, per 15 minutes
- S9484Crisis intervention mental health services, per hour
- S9485Crisis intervention mental health services, per diem
- S9490Home infusion therapy, corticosteroid infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem
- S9494Home infusion therapy, antibiotic, antiviral, or antifungal therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code with home infusion codes for hourly dosing schedules s9497-s9504)
- S9497Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 3 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem
Questions about S9475
What is HCPCS code S9475?
S9475 is a HCPCS Level II code for ambulatory setting substance abuse treatment or detoxification services, per diem. It sits in the Temporary National Codes (Non-Medicare) section.
Does Medicare cover S9475?
The CMS HCPCS file marks S9475 as "Not payable by Medicare". Medicare does not pay this code. It may still be valid for another payer, but a Medicare claim carrying it will not be reimbursed.
How is S9475 paid under the physician fee schedule?
S9475 carries PFS status code I. Not valid for Medicare purposes. Medicare uses another code.