Skip to Main Content

HCPCS - General Information

What's New

CMS has published a November 6 and 8, 2018 HCPCS update on our website which includes new codes inadvertently omitted from our published 2019 Annual update. 


CMS has published a November 6, 2018 HCPCS update on our website which includes a new code inadvertently omitted from our published 2019 Annual update.


The Centers for Medicare & Medicaid Services is pleased to announce the scheduled release of modifications to the 2019 Healthcare Common Procedure Coding System (HCPCS) code set. These changes have been posted to the https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/Alpha-Numeric-HCPCS.html. Final decisions for individual HCPCS code applications will be published soon, in this section.


CMS is pleased to announce that all interested parties unable to attend the HCPS Public Meetings for DMEPOS can Live Stream on You Tube:

For June 5, 2018, the live stream is as follows:

YouTube Public URLs

Morning Session: https://www.youtube.com/watch?v=pz3CaVcCfUg

Afternoon Session: https://www.youtube.com/watch?v=VBNz82G3TvM

For June 6, 2018, the live stream is as follows:

Morning Session: https://www.youtube.com/watch?v=D65mkvu48HQ

Afternoon Session: https://www.youtube.com/watch?v=EHFjuLMzYZo


CMS is pleased to announce that all interested parties unable to attend the HCPCS Public Meetings in person can Live Stream on YouTube. The Public URLs for May 14, 2018, and May 15, 2018, are listed below for each of these meetings.

For May 14, 2018, the Live stream link is as follows:

Afternoon Session: https://www.youtube.com/watch?v=oYwIivZnAGw

For May 15, 2018, the Live stream link is as follows:

Morning Session: https://www.youtube.com/watch?v=mvU35k5_R50

Afternoon Session: https://www.youtube.com/watch?v=KMHhzyxkkRs

For May 16, 2018, the Live stream link is as follows:

Morning Session: https://www.youtube.com/watch?v=rMZt4qFwT5s

Afternoon Session: https://www.youtube.com/watch?v=Wpkw7f2qhCg


CMS is pleased to announce the publication of our Agenda for June 5, 2018, for DMEPOS (Updated 5/23/18).

CMS is pleased to announce the publication of our Agenda for June 6, 2018, HCPCS Public Meeting for DMEPOS.

On-Line registration is now open for June 5 and June 6, 2018 at: https://www.cms.gov/apps/events/default.asp 


CMS is pleased to announce the publication of our Agenda for May 16, 2018, HCPCS Public Meeting for Drugs, Biologics and Radiopharmaceuticals.

On-line registration is open to all attendees for all days of the days of the Public Meetings at: https://www.cms.gov/apps/events/default.asp


CMS was significantly late in publishing Agendas for our series of HCPCS Public Meetings for Drugs, Biologicals and Radiopharmaceuticals for meeting dates May 14, 15, and 16, 2018. This is unprecedented, and due to circumstances beyond our control. We appreciate your patience, and sincerely apologize for any inconvenience we may have caused. Your input is very important to us, and as such, we have taken the following steps to ensure that we do not short-change applicants and the general public, in terms of time to provide comments.

We have extended our deadline for applicants to submit materials for presentation AT our Public Meetings to the latest possible date/time we can accept them, on a meeting to meeting basis, and we have notified our applicants under separate cover.

We are extending our deadline for all applicants whose requests appear on our May 14, 15, and 16, 2018 Public Meeting agendas; and also for the general public, to submit written comments for CMS' consideration, related to items on agendas for these meetings. This deadline is typically COB on the date of the public meeting. We are extending it to June 5, 2018. For comments are sent by e-mail, please specify in the subject line the Application Number and Public Meeting date.

As always, there is no requirement for Primary Speakers to provide A-V materials for presentation at Public Meeting. Primary Speakers may of course, provide verbal comments at our public meeting, even if A-V materials have not been submitted. And as always, Primary Speakers have the opportunity to provide written presentation materials (e.g., copies of a power-point presentation, and other written comments), the morning of the Public Meeting, for distribution at the meeting. In this case, the Primary Speaker or applicant is asked to provide the number of copies specified in our published "Guidelines for Participation in HCPCS Public Meetings".


CMS is pleased to announce the publication of our May 14, 2018, HCPCS Public Meeting agenda for Drugs, Biologics and Radiopharmaceuticals and now the May 15, 2018, HCPCS Public Meeting agenda for Drugs and Biologics and Radiopharmaceuticals.

Agenda for May 16, 2018 Public Meeting to follow.

Online registration is now open to attendees for May 14, 15, and 16, 2018: https://www.cms.gov/apps/events/default.asp


On March 21, 2018, CMS issued a correction to the Federal Register Notice [1683-N] that was originally published on February 28, 2018. This correction was made to the dates of the Durable Medical Equipment, Orthotics, Prosthetics and Supplies, (DMEPOS) Public meeting dates.

The correct dates for CMS’ 2018 Durable Medical Equipment, Orthotics, Prosthetics and Supplies (DMEPOS) HCPCS Public Meetings are as follows: Tuesday, June 5, 2018, 9 a.m. to 5 p.m., e.d.t. and Wednesday, June 6, 2018, 9 a.m. to 5 p.m., e.d.t.

The dates for CMS' Drugs/Biologicals/Radiopharmaceuticals/Radiologic Imaging Agents (Drug) HCPS Public Meetings are correct as issued.

However; all dates for the Drug meetings may not be needed. Please be sure to consult the actual Public Meeting agendas, once published.

Please contact CMS’ HCPCS Public Meeting Coordinator by email at Judi.Wallace@cms.hhs.gov or by phone at 410-786-3197, if you need further information.


The Centers for Medicare & Medicaid Services is pleased to announce the scheduled release of modifications to the Healthcare Common Procedure Coding System (HCPCS) code set.  These changes have been posted to the HCPCS Quarterly Update website. Changes are effective on the date indicated on the update.


The Centers for Medicare & Medicaid Services is pleased to announce the release of final decision information pertaining to individual Level II HCPCS code applications in the 2017-2018 HCPCS coding cycle.  This information is included in an Excel spreadsheet entitled " CMS Level II HCPCS Coding Decisions for the 2017-2018 Coding Cycle [ZIP, 56KB] ."

This release is part of CMS’ 3-phase plan for adding transparency to the Level II HCPCS coding process implemented in 2014.  Other phases also implemented this year include employing live-stream technology to enable remote attendance to CMS’ HCPCS Public Meetings; and the initiation of a demonstration for a web-based notice and comment mechanism for allowing public input on requests to discontinue Level II HCPCS codes that are generated internally based on national program operating needs; are not the subject of other notice and comment mechanisms; and that are not replaced by other or new codes.


The Centers for Medicare & Medicaid Services is pleased to announce the release of the 2017  HCPCS Application Summaries  for the 2017-2018 cycle. This release is a series of Application Summary documents arranged based on product category as presented in the CMS' 2017 HCPCS Public Meeting agendas and public meeting summaries.


The Centers for Medicare & Medicaid Services is pleased to announce the scheduled release of modifications to the 2019 Healthcare Common Procedure Coding System (HCPCS) code set. These changes have been posted to the Alpha-Numeric HCPCS code list. Final decisions for individual HCPCS code applications will be published soon, in this section.


CMS is pleased to announce the July 25, 2017 release of a Level II HCPCS Quarterly Update.


The HCPCS Public Meetings for June 7-8, 2017 can be live streamed on YouTube using the following links listed below:


The Centers for Medicare & Medicaid Services is pleased to announce that registration is now open for the June 7 and June 8 HCPCS Public Meetings for DMEPOS.

The links for registration can be found below:


The Centers for Medicare & Medicaid Services is pleased to announce that registration is now open for the May 16, May 17, and May 18, 2017 HCPCS Public Meetings. All individuals interested in attending CMS' HCPCS Public Meetings should use the links below to register online. Be sure to register separately for each individual meeting date you wish to attend.


CMS is pleased to publish the HCPCS Public Meeting Agenda for June 7, 2017. HCPCS Public Meeting Agenda for June 7, 2017 [PDF, 181KB]  


CMS is pleased to publish the HCPCS Public Meeting Agenda for June 8, 2017 HCPCS Public Meeting Agenda for June 8, 2017 [PDF, 440KB] .


The Centers for Medicare & Medicaid Services is pleased to announce the release of the May 18, 2017, HCPCS Public Meeting Agenda for Drugs and Biologics.


CMS is pleased to announce the release of the May 17, 2017 HCPCS Meeting Agenda for Drugs and Biologics.


The Centers for Medicare & Medicaid Services is pleased to announce the release of  2017 Guidelines for Participation [PDF, 81KB]  in Public Meetings for all new Public Requests for revisions to the Healthcare Common Procedure Coding System (HCPCS). Please refer to this document for instructions and useful information to attend any of the public meetings including deadlines for registration as a participant or as a primary speaker.


The Centers for Medicare & Medicaid Services is pleased to announce the release of the May 16, 2017 HCPCS Public Meeting Agenda for Drugs and Biologics. Additional Public Meeting Agendas for both May 17, 2017, and May 18, 2017, will be published soon.

This Public Meeting Agenda includes CMS' preliminary coding recommendations for external HCPCS code applications submitted for the 2017-2018 coding cycle. The summaries of each agenda item are arranged in the order in which they will be discussed at the public meeting.


CMS has released notice of new Internal HCPCS Coding Decisions on July 5, 2016. Use the following link to view the document and instructions for submitting comments:   CMS Internal HCPCS Coding Decisions


The Centers for Medicare & Medicaid Services is pleased to announce the scheduled release of modifications to the Healthcare Common Procedure Coding System (HCPCS) code set.  These changes have been posted to the HCPCS Quarterly Update website. Changes are effective on the date indicated on the update.


The Centers for Medicare & Medicaid Services announces the release of a revised March 2017 Quarterly Update Chart for “Other Codes Effective July 1, 2017”. The revised Quarterly HCPCS update includes new coding actions effective July 1, 2017, that were not included in the previously published file. The revised file has been posted to CMS’ HCPCS website at HCPCS Quarterly Update . The coding changes are effective on the date indicated in the update.


The Centers for Medicare & Medicaid Services is pleased to announce the scheduled release of modifications to the Healthcare Common Procedure Coding System (HCPCS) code set.  These changes have been posted to the HCPCS website at http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/HCPCS_Quarterly_Update.html.  Changes are effective on the date indicated on the update.


CMS has released notice that the proposed revisions to HCPCS Level II Miscellaneous codes will not be implemented in 2016:   CMS Internal HCPCS Coding Decisions [PDF, 50KB] .


The Centers for Medicare & Medicaid Services Level II HCPCS Code application deadline for the 2018-2019 coding cycle is January 4, 2018. The updated application form and instructions, including the revised application deadline, is posted at  2019 Application & Instructions [PDF, 105KB] .


The Centers for Medicare & Medicaid Services is pleased to announce its plans to initiate a limited demonstration for web-based notice and comment mechanism for allowing public input on requests to discontinue Level II HCPCS codes, that are generated internally based on national program operating needs, are not the subject of other notice and comment mechanisms; and that are not replaced by other or new codes.

This demonstration will add further transparency to CMS’ HCPCS coding process by providing advance notice regarding internal decisions to discontinue HCPCS codes and an opportunity for public input into these decisions.  Additionally, this demonstration provides a valuable opportunity for CMS to gather critical data related to the logistics, time and resources involved in adding a public component to CMS’ internal code request process, so that we can find an appropriate balance between the need for transparency and stakeholder input, and the  need to be nimble in making coding changes to improve program administration, to the extent practicable. 

CMS reserves the right to make immediate changes without notice (and take comments afterwards), when we have a national program operating need to do so.

The first year of the demonstration will be conducted in the current (2014/2015) HCPCS coding cycle.  Afterwards, CMS will consider the results of the demonstration.

The timing and logistics of the demonstration, as follows, will also be discussed in CMS’ “Level II Coding Procedures” document, published at the HCPCS Level II Coding Process & Criteria web page.

Summaries of internal requests to discontinue permanent level II HCPCS codes (that are not the subject of other notice and comment mechanisms and/or that are not replaced by other or new codes) are published by July 1, 2017, on the CMS Internal HCPCS Coding Decisions web page.

Public comments are due, in writing, via hcpcs@cms.hhs.gov by July 21, 2017.

CMS’ HCPCS Workgroup will re-review the internal requests, together with input received timely via the above process. The final decision will be folded into the outgoing HCPCS Annual Update.

CMS has additional plans for adding transparency to the Level II HCPCS coding process, which include employing live-stream technology to enable remote attendance to CMS’ HCPCS Public meetings, effective as of the 2014 CMS’ HCPCS public meetings.  Details are published in our document entitled: “Guidelines for Participation in CMS’ HCPCS Public Meetings" on CMS’ official HCPCS website. CMS is also developing a mechanism to share information pertaining to final decisions for individual HCPCS code applications. 


 

HCPCS Background Information

Each year, in the United States, health care insurers process over 5 billion claims for payment. For Medicare and other health insurance programs to ensure that these claims are processed in an orderly and consistent manner, standardized coding systems are essential. The HCPCS Level II Code Set is one of the standard code sets used for this purpose. The HCPCS is divided into two principal subsystems, referred to as level I and level II of the HCPCS. Level I of the HCPCS is comprised of CPT (Current Procedural Terminology), a numeric coding system maintained by the American Medical Association (AMA). The CPT is a uniform coding system consisting of descriptive terms and identifying codes that are used primarily to identify medical services and procedures furnished by physicians and other health care professionals. These health care professionals use the CPT to identify services and procedures for which they bill public or private health insurance programs. Decisions regarding the addition, deletion, or revision of CPT codes are made by the AMA. The CPT codes are republished and updated annually by the AMA. Level I of the HCPCS, the CPT codes, does not include codes needed to separately report medical items or services that are regularly billed by suppliers other than physicians.

Level II of the HCPCS is a standardized coding system that is used primarily to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when used outside a physician's office. Because Medicare and other insurers cover a variety of services, supplies, and equipment that are not identified by CPT codes, the level II HCPCS codes were established for submitting claims for these items. The development and use of level II of the HCPCS began in the 1980's. Level II codes are also referred to as alpha-numeric codes because they consist of a single alphabetical letter followed by 4 numeric digits, while CPT codes are identified using 5 numeric digits.

.