S9124 HCPCS Code: Nursing care (Units, EVV, Rates, Denials)

S9124 is “Nursing care, in the home; by licensed practical nurse, per hour.” It is billed per hour and covers hourly LPN care in the home, often called private duty or shift nursing. Medicare does not pay it. EVV is required for Medicaid home health services, and some states also require it for private duty nursing; check your state.

Units and rounding

One unit is one hour. Partial hours follow the payer’s manual; some payers pay quarter-hour fractions and others only full hours. Convert minutes in the units calculator.

Modifiers you will see

• U1–U9: State-defined; often distinguish programs (waiver vs state plan), service levels or provider types
• TT: Individualized service provided to more than one patient in the same setting
• TE: Service delivered by an LPN/LVN

Modifier meanings are set by each state and payer, so check your provider manual. See home care billing modifiers.

Typical rates

Hourly nursing rates differ by payer and state. Each state program and managed-care plan sets its own rate, so use your state’s current fee schedule. Check what is left of an hour after wages and overhead with the Medicaid hour margin calculator.

Common denial reasons

• Hours exceed the authorization
• No current physician order or plan of care
• Missing or mismatched EVV visit, where the state requires it
• Service date outside the authorization period

Related codes

• S9123: Nursing care, in the home; by registered nurse, per hour
• T1031: Nursing care, in the home, by licensed practical nurse, per diem
• G0300: Direct skilled nursing services of a licensed practical nurse (LPN) in the home health or hospice setting, each 15 minutes

Source

CMS HCPCS Level II code set (quarterly update). Confirm the exact descriptor and any state-specific unit definition in your payer’s billing manual. Last reviewed November 6, 2026.

General information, not billing or legal advice. Check your state Medicaid agency’s current fee schedule and provider manual.