Summary & Overview
HCPCS Level II S9122: Home Health Aide or CNA, Per Hour
Headline: HCPCS Level II code S9122 covers hourly home health aide care in the home
Lead: HCPCS Level II code S9122 represents hourly personal care delivered by a home health aide or certified nurse assistant in the patient’s home. The code is widely used across payer types to document and bill for direct in-home assistance with activities of daily living and similar personal care services.
What the code represents and why it matters: S9122 codes the provision of paid personal care by trained aides in the home. As the population ages and the preference for home-based care grows, accurate coding for aide hours affects service documentation, access to supportive care, and administrative reporting across health plans and care programs.
Key payers covered: Analysis and guidance commonly reference major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare.
Overview of what readers will learn: This publication outlines the clinical and billing context for S9122, describes typical sites of service and use cases, and compares S9122 to related home care codes for nursing and personal care time accounting. It flags areas where billing differentiation matters for service lines and payer adjudication. Where specific reimbursement or service-line metadata is unavailable, the text will note "Data not available in the input."
Billing Code Overview
HCPCS Level II code S9122 describes home health aide or certified nurse assistant services provided in the home on an hourly basis. The service type is Home health aide/service, and the typical site of service is the home setting (POS 12). This code is used to bill for direct personal care and assistance delivered by a home health aide or certified nurse assistant during visits in the beneficiary's residence.
Clinical & Coding Specifications
Clinical Context
A homebound older adult with limited mobility and difficulty performing activities of daily living (ADLs) receives hourly home health aide support. The patient requires assistance with bathing, dressing, toileting, ambulation within the home, and routine household safety monitoring. A home health agency nurse assesses the patient, establishes a care plan, and schedules aide visits in the patients home (Place of Service 12). The home health aide or certified nurse assistant documents start and stop times for each visit, reports changes to the supervising registered nurse, and provides hands-on personal care and basic observation during each hour of service.
Coding Specifications
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HCPCS Level II code
S9122description: Home health aide or certified nurse assistant, providing care in the home; per hour. -
Common Modifiers:
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TT— Individualized service provided to more than one patient in the same setting. Use when a single aide provides individualized services to multiple patients in the same location during the billed time period. -
52— Reduced Services. Use when the service provided is partially reduced or discontinued at the physicians or supervising providers direction or when less than the full service was furnished. -
Associated provider taxonomies:
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251E00000X— Home Health Agency (represents an organizational provider delivering home health services). -
376J00000X— Home Health Aide (represents the aide/certified nurse assistant providing personal care services). -
163WH0200X— Home Health Registered Nurse (represents the registered nurse who supervises home health services and care planning).
Related Diagnoses
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Z74.01— Need for assistance with personal care. Clinically relevant as a direct indication for home health aide services when a patient cannot safely perform ADLs independently. -
Z74.3— Need for continuous supervision. Clinically relevant when ongoing observation is required and aide presence supports safety and monitoring in the home. -
Z74.8— Other problems related to care provider dependency. Clinically relevant when dependency on care providers necessitates arranged home aide services. -
Z74.9— Problem related to care provider dependency, unspecified. Clinically relevant as a general descriptor for care dependency that can justify personal care aide services. -
Z73.6— Limitation of activities due to disability. Clinically relevant when activity limitations impair self-care and support the need for home health aide assistance.
Related Codes
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S9123— Nursing care, in the home; by registered nurse, per hour. This is a higher-skill nursing visit billed when a registered nurse provides skilled nursing assessment or treatment during home visits; often billed instead of or in addition to aide hours when skilled nursing is required. -
S9124— Nursing care, in the home; by licensed practical nurse, per hour. Billed when a licensed practical nurse provides nursing care in the home; may be used as an alternative depending on skill level required. -
T1019— Personal care services, per 15 minutes. Represents personal care services billed in 15-minute units; can be used for more granular time-based billing when payer rules allow or when services are billed in quarter-hour increments instead of per hour. -
G0156— Services of home health/hospice aide in home health or hospice settings, each 15 minutes. Commonly used for Medicare billing in 15-minute units and may be used in workflows that require Medicare-specific billing instead of or alongsideS9122. -
Common usage notes:
S9122is an hourly home health aide code and may be billed alone for unskilled personal care.S9123andS9124indicate nursing visits when clinical skilled care is provided.T1019andG0156are 15-minute personal care/aide service codes used as alternatives or for payers that require quarter-hour reporting. When time units are converted between hourly and 15-minute codes, payer-specific rules determine allowed combinations.
National Reimbursement Benchmarks
For HCPCS Level II code S9122 the national mean rate landscape places Medicare and Aetna at the same mean rate ($15.00), while Blue Cross Blue Shield has the highest mean rate at $26.06 and Cigna Health the lowest at $9.35. BUCA (average commercial) has a mean rate of $15.84, closely aligned with Medicare and Aetna; UnitedHealthcare's mean is $17.24.
Rate dispersion varies notably across payers. Blue Cross Blue Shield shows one of the widest spreads between the 75th and 25th percentiles (31.00 - 16.83 = 14.17), indicating greater variability. BUCA also shows moderate dispersion (17.89 - 9.50 = 8.39). Cigna Health is the tightest with no dispersion (4.00 - 4.00 = 0.00). Aetna and Medicare are identical and show no dispersion (15.00 - 15.00 = 0.00). UnitedHealthcare shows a wide relative dispersion driven by a 25th percentile of $0.00 (21.00 - 0.00 = 21.00).
The table and chart below present the full breakdown of national mean rates and percentile values for each payer.
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