S-code: Temporary national codes (non-Medicare) Temporary national codes (non-Medicare)

533 codes

Billing context

S-codes are temporary national codes established for private payers and Medicaid programs. They are not payable by Medicare; whether a payer recognizes an S-code, and how it pays, varies by payer and contract.

S-codes, page 1 of 6
Code	Long descriptor	Payment limit (Q4 2026)	Added	Status
S0012	Butorphanol tartrate, nasal spray, 25 mg	—	Jan 1, 2000	Active
S0013	Esketamine, nasal spray, 1 mg	—	Jan 1, 2021	Ended Dec 31, 2025
S0014	Tacrine hydrochloride, 10 mg	—	Jan 1, 2000	Active
S0017	Injection, aminocaproic acid, 5 grams	—	Jan 1, 2000	Ended Mar 31, 2025
S0020	Injection, bupivicaine hydrochloride, 30 ml	—	Jan 1, 2000	Ended Jun 30, 2023
S0021	Injection, cefoperazone sodium, 1 gram	—	Jan 1, 2000	Active
S0023	Injection, cimetidine hydrochloride, 300 mg	—	Jan 1, 2000	Active
S0028	Injection, famotidine, 20 mg	—	Jan 1, 2000	Ended Mar 31, 2025
S0030	Injection, metronidazole, 500 mg	—	Jan 1, 2000	Ended Jun 30, 2023
S0032	Injection, nafcillin sodium, 2 grams	—	Jan 1, 2000	Ended Mar 31, 2025
S0034	Injection, ofloxacin, 400 mg	—	Jan 1, 2000	Active
S0039	Injection, sulfamethoxazole and trimethoprim, 10 ml	—	Jan 1, 2000	Ended Mar 31, 2025
S0040	Injection, ticarcillin disodium and clavulanate potassium, 3.1 grams	—	Jan 1, 2000	Active
S0073	Injection, aztreonam, 500 mg	—	Jan 1, 2000	Ended Jun 30, 2023
S0074	Injection, cefotetan disodium, 500 mg	—	Jan 1, 2000	Ended Sep 30, 2025
S0077	Injection, clindamycin phosphate, 300 mg	—	Jan 1, 2000	Ended Jun 30, 2023
S0078	Injection, fosphenytoin sodium, 750 mg	—	Jan 1, 2000	Active
S0080	Injection, pentamidine isethionate, 300 mg	—	Jan 1, 2000	Ended Dec 31, 2025
S0081	Injection, piperacillin sodium, 500 mg	—	Jan 1, 2000	Active
S0088	Imatinib, 100 mg	—	Jan 1, 2002	Active
S0090	Sildenafil citrate, 25 mg	—	Jan 1, 2000	Active
S0091	Granisetron hydrochloride, 1 mg (for circumstances falling under the medicare statute, use q0166)	—	Jan 1, 2002	Active
S0092	Injection, hydromorphone hydrochloride, 250 mg (loading dose for infusion pump)	—	Jan 1, 2002	Active
S0093	Injection, morphine sulfate, 500 mg (loading dose for infusion pump)	—	Jan 1, 2002	Active
S0104	Zidovudine, oral, 100 mg	—	Oct 1, 2002	Active
S0106	Bupropion hcl sustained release tablet, 150 mg, per bottle of 60 tablets	—	Apr 1, 2002	Active
S0108	Mercaptopurine, oral, 50 mg	—	Apr 1, 2002	Active
S0109	Methadone, oral, 5 mg	—	Oct 1, 2004	Active
S0117	Tretinoin, topical, 5 grams	—	Jul 1, 2004	Active
S0119	Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code)	—	Jan 1, 2012	Active
S0122	Injection, menotropins, 75 iu	—	Apr 1, 2002	Active
S0126	Injection, follitropin alfa, 75 iu	—	Apr 1, 2002	Active
S0128	Injection, follitropin beta, 75 iu	—	Apr 1, 2002	Active
S0132	Injection, ganirelix acetate, 250 mcg	—	Apr 1, 2002	Active
S0136	Clozapine, 25 mg	—	Apr 1, 2003	Active
S0137	Didanosine (ddi), 25 mg	—	Apr 1, 2003	Active
S0138	Finasteride, 5 mg	—	Apr 1, 2003	Active
S0139	Minoxidil, 10 mg	—	Apr 1, 2003	Active
S0140	Saquinavir, 200 mg	—	Apr 1, 2003	Active
S0142	Colistimethate sodium, inhalation solution administered through dme, concentrated form, per mg	—	Apr 1, 2005	Active
S0144	Injection, propofol, 10 mg	—	Jul 1, 2014	Ended Dec 31, 2014
S0145	Injection, pegylated interferon alfa-2a, 180 mcg per ml	—	Jul 1, 2005	Active
S0148	Injection, pegylated interferon alfa-2b, 10 mcg	—	Oct 1, 2010	Active
S0155	Sterile dilutant for epoprostenol, 50 ml	—	Jan 1, 2002	Active
S0156	Exemestane, 25 mg	—	Jan 1, 2001	Active
S0157	Becaplermin gel 0.01%, 0.5 gm	—	Jan 1, 2001	Active
S0160	Dextroamphetamine sulfate, 5 mg	—	Apr 1, 2004	Active
S0164	Injection, pantoprazole sodium, 40 mg	—	Apr 1, 2004	Ended Jun 30, 2024
S0166	Injection, olanzapine, 2.5 mg	—	Oct 1, 2004	Ended Sep 30, 2023
S0169	Calcitrol, oral, 0.25 microgram	—	Oct 1, 2010	Active
S0170	Anastrozole, oral, 1 mg	—	Jan 1, 2002	Active
S0171	Injection, bumetanide, 0.5 mg	—	Jan 1, 2002	Ended Dec 31, 2023
S0172	Chlorambucil, oral, 2 mg	—	Jan 1, 2002	Active
S0174	Dolasetron mesylate, oral 50 mg (for circumstances falling under the medicare statute, use q0180)	—	Jan 1, 2002	Active
S0175	Flutamide, oral, 125 mg	—	Jan 1, 2002	Active
S0176	Hydroxyurea, oral, 500 mg	—	Jan 1, 2002	Active
S0177	Levamisole hydrochloride, oral, 50 mg	—	Jan 1, 2002	Active
S0178	Lomustine, oral, 10 mg	—	Jan 1, 2002	Active
S0179	Megestrol acetate, oral, 20 mg	—	Jan 1, 2002	Active
S0182	Procarbazine hydrochloride, oral, 50 mg	—	Jan 1, 2002	Active
S0183	Prochlorperazine maleate, oral, 5 mg (for circumstances falling under the medicare statute, use q0164)	—	Jan 1, 2002	Active
S0187	Tamoxifen citrate, oral, 10 mg	—	Jan 1, 2002	Active
S0189	Testosterone pellet, 75 mg	—	Jan 1, 2002	Ended Dec 31, 2025
S0190	Mifepristone, oral, 200 mg	—	Jan 1, 2001	Active
S0191	Misoprostol, oral, 200 mcg	—	Jan 1, 2001	Active
S0194	Dialysis/stress vitamin supplement, oral, 100 capsules	—	Apr 1, 2004	Active
S0195	Pneumococcal conjugate vaccine, polyvalent, intramuscular, for children from five years to nine years of age who have not previously received the vaccine	—	Jan 1, 2003	Ended Dec 31, 2015
S0197	Prenatal vitamins, 30-day supply	—	Apr 1, 2005	Active
S0199	Medically induced abortion by oral ingestion of medication including all associated services and supplies (e.g., patient counseling, office visits, confirmation of pregnancy by hcg, ultrasound to confirm duration of pregnancy, ultrasound to confirm completion of abortion) except drugs	—	Jan 1, 2001	Active
S0201	Partial hospitalization services, less than 24 hours, per diem	—	Oct 1, 2002	Active
S0207	Paramedic intercept, non-hospital-based als service (non-voluntary), non-transport	—	Oct 1, 2002	Active
S0208	Paramedic intercept, hospital-based als service (non-voluntary), non-transport	—	Jan 1, 2002	Active
S0209	Wheelchair van, mileage, per mile	—	Jan 1, 2002	Active
S0215	Non-emergency transportation; mileage, per mile	—	Jan 1, 2002	Active
S0220	Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient is present); approximately 30 minutes	—	Jan 1, 2001	Active
S0221	Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient is present); approximately 60 minutes	—	Jan 1, 2001	Active
S0250	Comprehensive geriatric assessment and treatment planning performed by assessment team	—	Jan 1, 2002	Active
S0255	Hospice referral visit (advising patient and family of care options) performed by nurse, social worker, or other designated staff	—	Jan 1, 2002	Active
S0257	Counseling and discussion regarding advance directives or end of life care planning and decisions, with patient and/or surrogate (list separately in addition to code for appropriate evaluation and management service)	—	Jan 1, 2005	Active
S0260	History and physical (outpatient or office) related to surgical procedure (list separately in addition to code for appropriate evaluation and management service)	—	Jan 1, 2002	Active
S0265	Genetic counseling, under physician supervision, each 15 minutes	—	Jul 1, 2005	Active
S0270	Physician management of patient home care, standard monthly case rate (per 30 days)	—	Apr 1, 2007	Active
S0271	Physician management of patient home care, hospice monthly case rate (per 30 days)	—	Apr 1, 2007	Active
S0272	Physician management of patient home care, episodic care monthly case rate (per 30 days)	—	Apr 1, 2007	Active
S0273	Physician visit at member's home, outside of a capitation arrangement	—	Apr 1, 2007	Active
S0274	Nurse practitioner visit at member's home, outside of a capitation arrangement	—	Apr 1, 2007	Active
S0280	Medical home program, comprehensive care coordination and planning, initial plan	—	Jan 1, 2010	Active
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	—	Jan 1, 2010	Active
S0285	Colonoscopy consultation performed prior to a screening colonoscopy procedure	—	Jul 1, 2016	Active
S0302	Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)	—	Jan 1, 2002	Active
S0310	Hospitalist services (list separately in addition to code for appropriate evaluation and management service)	—	Jan 1, 2002	Active
S0311	Comprehensive management and care coordination for advanced illness, per calendar month	—	Jul 1, 2016	Active
S0315	Disease management program; initial assessment and initiation of the program	—	Oct 1, 2002	Active
S0316	Disease management program, follow-up/reassessment	—	Oct 1, 2002	Active
S0317	Disease management program; per diem	—	Jul 1, 2003	Active
S0320	Telephone calls by a registered nurse to a disease management program member for monitoring purposes; per month	—	Oct 1, 2002	Active
S0340	Lifestyle modification program for management of coronary artery disease, including all supportive services; first quarter / stage	—	Jan 1, 2002	Active
S0341	Lifestyle modification program for management of coronary artery disease, including all supportive services; second or third quarter / stage	—	Jan 1, 2002	Active
S0342	Lifestyle modification program for management of coronary artery disease, including all supportive services; fourth quarter / stage	—	Jan 1, 2002	Active
S0353	Treatment planning and care coordination management for cancer, initial treatment	—	Apr 1, 2012	Active