S9110 Codes Reference
Quick reference guide to S9110 billing codes and modifiers for Texas Medicaid RPM.
Your comprehensive reference for S9110 billing codes used in Texas Medicaid Remote Patient Monitoring. This guide provides detailed information on each modifier, billing requirements, documentation needs, and real-world examples to help you maximize reimbursement.
Downloads
- S9110 Quick Reference Card PDF
- Modifier Selection Flowchart PDF
- Billing Examples Guide PDF
S9110 Code Overview
S9110 is the HCPCS Level II code designated by Texas Medicaid for Remote Patient Monitoring services. This code is unique to Texas Medicaid and differs from Medicare's CPT-based RPM codes.
Modifier U1: Initial Setup
The U1 modifier covers the initial patient setup, equipment delivery, device pairing, and training.
S9110-U1
$50.00Initial Setup and Patient Training
Billing Requirements:
- ✓Billed once per patient at program enrollment
- ✓Can be billed in addition to monitoring modifiers (U2-U9)
- ✓Requires documentation of equipment delivery
- ✓Must document patient/caregiver training
- ✓Device pairing and initial reading verification required
Required Documentation:
- ✓Equipment delivery confirmation with date/time
- ✓Device serial numbers and pairing status
- ✓Patient training checklist completed
- ✓Initial baseline readings captured
- ✓Patient demonstration of proper device use
Modifier U2: 1-5 Monitoring Days
U2 modifier is for minimal monitoring (1-5 days of patient readings in a 30-day period).
S9110-U2
$40.101-5 Monitoring Days
Billing Requirements:
- ✓Patient must have 1-5 days with valid readings
- ✓Days do not need to be consecutive
- ✓Each day requires at least one reading per ordered vital sign
- ✓Care coordination activities must be documented
Required Documentation:
- ✓Reading logs showing dates and values
- ✓Alert documentation if applicable
- ✓Patient communication records
- ✓Care coordination notes
Modifier U3: 6-10 Monitoring Days
U3 modifier represents basic monitoring with 6-10 days of patient readings.
S9110-U3
$80.196-10 Monitoring Days
Billing Requirements:
- ✓Patient must have 6-10 days with valid readings
- ✓Regular care team review of readings required
- ✓Document response to any abnormal readings
- ✓Patient communication regarding adherence
Required Documentation:
- ✓Daily reading logs (6-10 days)
- ✓Care team review notes
- ✓Intervention documentation
- ✓Patient outreach records
Modifier U4: 11-15 Monitoring Days
U4 modifier indicates standard monitoring with 11-15 days of patient readings.
S9110-U4
$120.2911-15 Monitoring Days
Billing Requirements:
- ✓Patient must have 11-15 days with valid readings
- ✓Demonstrates consistent patient engagement
- ✓Regular care team oversight documented
- ✓Any alerts or interventions documented
Required Documentation:
- ✓Reading logs (11-15 days)
- ✓Weekly care team reviews
- ✓Alert response documentation
- ✓Patient communication logs
Modifier U7: 16-20 Monitoring Days
U7 modifier represents enhanced monitoring with 16-20 days of readings.
S9110-U7
$160.3816-20 Monitoring Days
Billing Requirements:
- ✓Patient must have 16-20 days with valid readings
- ✓Indicates strong patient adherence
- ✓Comprehensive care coordination documented
- ✓Proactive patient engagement strategies employed
Required Documentation:
- ✓Reading logs (16-20 days)
- ✓Comprehensive care notes
- ✓Trend analysis documentation
- ✓Patient engagement records
Modifier U8: 21-25 Monitoring Days
U8 modifier reflects comprehensive monitoring with 21-25 days of readings.
S9110-U8
$200.4821-25 Monitoring Days
Billing Requirements:
- ✓Patient must have 21-25 days with valid readings
- ✓Excellent patient compliance and engagement
- ✓Intensive care coordination activities
- ✓Regular communication with patient and care team
Required Documentation:
- ✓Reading logs (21-25 days)
- ✓Detailed care coordination notes
- ✓Clinical decision-making documentation
- ✓Patient outcome tracking
Modifier U9: 26-30 Monitoring Days
U9 modifier is the highest level, representing maximum monitoring with 26-30 days of readings.
S9110-U9
$240.5726-30 Monitoring Days
Billing Requirements:
- ✓Patient must have 26-30 days with valid readings
- ✓Exceptional patient adherence
- ✓Maximum care coordination and oversight
- ✓Comprehensive documentation of all activities
Required Documentation:
- ✓Reading logs (26-30 days)
- ✓Comprehensive monthly summary
- ✓All interventions documented
- ✓Complete patient interaction record
- ✓Outcomes and care plan adjustments
Billing Examples
Real-world scenarios demonstrating proper S9110 coding.
New Patient - Full Month
Patient enrolled on Day 1, took readings for 28 days
Established Patient - Good Compliance
Patient took readings for 22 days in billing period
Patient with Adherence Issues
Patient only took readings for 8 days despite outreach
Mid-Month Enrollment
Patient enrolled on Day 15, took readings for remaining 12 days
Maximize Your S9110 Revenue
Our platform automatically tracks monitoring days and selects the correct modifier for billing.
See How It Works