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PAYER POLICY CHANGES

S9364 Insurance Policy Changes

HCPCS S9364 is officially defined as "Home infusion therapy, total parenteral nutrition (tpn); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem (do not use with home infusion codes s9365-s9368 using daily volume scales)." HCPCS S9364 is referenced in 5 tracked payer policy changes from Blue Cross & Blue Shield of Mississippi, Independence Blue Cross, and 2 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS S9364 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

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REFERENCE DATA

Payers with rules10
Payers requiring prior auth10
  • Anthem BCBS · Effective November 1, 2026

    Prior authorization required

    Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial)

  • Elevance Health · Effective February 11, 2026

    Prior authorization required

    List of items and services that require prior authorization (Medicaid GA)

  • BCBS Illinois · Effective January 1, 2026

    Prior authorization required in some cases

    2026 Commercial Outpatient Medical Surgical Prior Authorization Codes

FREQUENTLY ASKED QUESTIONS

Does Anthem BCBS require prior authorization for S9364?

Anthem BCBS lists S9364 on Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial) for commercial plans (list dated November 1, 2026). Verify with the payer before scheduling.

Does BCBS Illinois require prior authorization for S9364?

BCBS Illinois lists S9364 on 2026 Commercial Outpatient Medical Surgical Prior Authorization Codes for commercial plans, with conditions (list dated January 1, 2026). Verify with the payer before scheduling.

Does BCBS Montana require prior authorization for S9364?

BCBS Montana lists S9364 on 2026 Commercial Medical Surgical Prior Authorization Codes for commercial plans, with conditions (list dated January 1, 2026). Verify with the payer before scheduling.

Does BCBS New Mexico require prior authorization for S9364?

BCBS New Mexico lists S9364 on 2026 Commercial Outpatient Medical Surgical ASO Medical Surgical Procedure Code List for commercial plans, with conditions (list dated January 1, 2026). Verify with the payer before scheduling.

Does BCBS Oklahoma require prior authorization for S9364?

BCBS Oklahoma lists S9364 on 2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes for commercial plans, with conditions (list dated January 1, 2026). Verify with the payer before scheduling.

What insurance policy changes affect HCPCS S9364?

There are 5 tracked policy changes affecting HCPCS S9364, including updates from Blue Cross & Blue Shield of Mississippi, Independence Blue Cross, Excellus BlueCross BlueShield. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS S9364?

Payers that have issued tracked updates for HCPCS S9364 include: Blue Cross & Blue Shield of Mississippi, Independence Blue Cross, Excellus BlueCross BlueShield, Aetna.

How do I get notified when HCPCS S9364 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS S9364. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for HCPCS S9364?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

See every payer rule for S9364

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for S9364 in one place.

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