S5497 HCPCS Level II code: Home infusion therapy, catheter care / maintenance, not otherwise classified; includes administrative services, professional pharmacy services, care…
S5497 is the HCPCS code for “Home infusion therapy, catheter care / maintenance, not otherwise classified; includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and…” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
S5497Home infusion therapy, catheter care / maintenance, not otherwise classified; includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem
Short description: Hit cath care noc
HCPCS · United States
Notes for S5497
As CMS prints them, with any note S5497 takes from the headings above it.
Note
- CMS processing note 0088: "S" CODES ARE UNIQUE TEMPORARY CODES ESTABLISHED BY BCBSA AND HIAA FOR PRIVATE PAYOR USE. THEY ARE NOT VALID NOR PAYABLE BY MEDICARE.
Medicare details
The indicators CMS publishes with S5497 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Not payable by Medicare
- Medicare pricing
- Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)
- Type of service
- Other medical items or services
- BETOS category
- Undefined codes
- Added
- Jan 1, 2002
Where S5497 sits
- 1S codesTemporary national codes (non-Medicare)
- 2Active code S5497Home infusion therapy, catheter care / maintenance, not otherwise classified; includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem
Source and release
- Data release
- HCPCS Level II · October 2026
- Effective date
- Oct 1, 2026
- Publisher
- CMS
This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.
Frequently asked questions
What does HCPCS code S5497 mean?
S5497 is the HCPCS code for “Home infusion therapy, catheter care / maintenance, not otherwise classified; includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover S5497?
CMS lists S5497’s Medicare coverage as “Not payable by Medicare” and its pricing as “Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.
Which HCPCS Level II release does this page use?
It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.
Codes beside S5497
All S codesS5175Laundry service, external, professional; per orderS5180Home health respiratory therapy, initial evaluationS5181Home health respiratory therapy, nos, per diemS5185Medication reminder service, non-face-to-face; per monthS5190Wellness assessment, performed by non-physicianS5199Personal care item, nos, eachS5498Home infusion therapy, catheter care / maintenance, simple (single lumen), includes administrative services, professional pharmacy services, care coordination and all necessary…S5501Home infusion therapy, catheter care / maintenance, complex (more than one lumen), includes administrative services, professional pharmacy services, care coordination, and all…S5502Home infusion therapy, catheter care / maintenance, implanted access device, includes administrative services, professional pharmacy services, care coordination and all necessary…S5517Home infusion therapy, all supplies necessary for restoration of catheter patency or declottingS5518Home infusion therapy, all supplies necessary for catheter repairS5520Home infusion therapy, all supplies (including catheter) necessary for a peripherally inserted central venous catheter (picc) line insertion