S9986: Not medically necessary service (patient is aware that service not medically necessary)
S9986 is a HCPCS Level II code for not medically necessary service (patient is aware that service not medically necessary). 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 2026Q4-Oct. 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 S9986
- Long descriptor
- Not medically necessary service (patient is aware that service not medically necessary)
- Short descriptor
- Not medically necessary svc
- Added
- January 1, 2002
- 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 S9986
HCPCS has no hierarchy: related items simply sit next to each other in the numbering. If S9986 is not quite right, the correct code is very often within a few positions of it.
- S9960Ambulance service, conventional air service, nonemergency transport, one way (fixed wing)
- S9961Ambulance service, conventional air service, nonemergency transport, one way (rotary wing)
- S9970Health club membership, annual
- S9975Transplant related lodging, meals and transportation, per diem
- S9976Lodging, per diem, not otherwise classified
- S9977Meals, per diem, not otherwise specified
- S9981Medical records copying fee, administrative
- S9982Medical records copying fee, per page
- S9988Services provided as part of a phase i clinical trial
- S9989Services provided outside of the united states of america (list in addition to code(s) for service(s))
- S9990Services provided as part of a phase ii clinical trial
- S9991Services provided as part of a phase iii clinical trial
- S9992Transportation costs to and from trial location and local transportation costs (e.g., fares for taxicab or bus) for clinical trial participant and one caregiver/companion
- S9994Lodging costs (e.g., hotel charges) for clinical trial participant and one caregiver/companion
- S9996Meals for clinical trial participant and one caregiver/companion
- S9999Sales tax