S0091 – Granisetron hydrochloride, 1 mg (for circumstances falling under the medicare statute, use q0166)

HCPCS Level II code · S codes: Temporary National Codes (Non-Medicare)

Active code Not payable by Medicare

HCPCS codeS0091
Long description
Granisetron hydrochloride, 1 mg (for circumstances falling under the medicare statute, use q0166)
Short description
Granisetron 1mg
Pricing indicator
00 Not separately priced by Part B (bundled, not covered or Part A only)
Medicare coverage
I Not payable by Medicare
BETOS category
Z2 Undefined codes
Added
January 1, 2002
Last change
July 1, 2001 – No change

Frequently asked questions

What is HCPCS code S0091?

S0091 is a HCPCS Level II code for granisetron hydrochloride, 1 mg (for circumstances falling under the medicare statute, use q0166).

Does Medicare cover S0091?

The HCPCS file lists coverage code I: Not payable by Medicare. Coverage and payment also depend on local coverage determinations and the patient’s plan.

Nearby S codes

Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.