S9475 Ambulatory setting substance
Also known as: substance abuse program, addiction counseling, chemical dependency treatment
Ambulatory setting substance abuse or chemical dependency treatment program or counseling services provided by licensed addiction specialists.
In Plain Language
substance abuse treatment; addiction program; drug/alcohol counseling
Clinical Context
Used for alcohol use disorder, opioid use disorder, and other substance use disorders. Part of comprehensive treatment including counseling, group therapy, and relapse prevention.
RVU Information
CPT S9475 does not have a physician work RVU assigned by CMS. This is typical for supply, drug, and equipment codes — reimbursement is based on Average Sales Price (ASP), fee schedules, or payer contracts rather than the RVU system.
Billing & Documentation
S-codes are used by private payers (not Medicare) for services without a standard CPT or HCPCS code. Coverage varies significantly between insurers. Verify payer acceptance before billing and document medical necessity thoroughly.
Specialties
Frequently Asked Questions
What is CPT code S9475?
CPT S9475 (Ambulatory setting substance) is a S Codes code. Ambulatory setting substance abuse or chemical dependency treatment program or counseling services provided by licensed addiction specialists.
Is S9475 covered by insurance?
S9475 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Used for alcohol use disorder, opioid use disorder, and other substance use disorders. Part of comprehensive treatment including counseling, group therapy, and relapse prevention.
When is CPT S9475 used?
Used for alcohol use disorder, opioid use disorder, and other substance use disorders. Part of comprehensive treatment including counseling, group therapy, and relapse prevention.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.