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PUBLICATION OF PUBLIC MEETING MATERIALS FOR THE FIRST 2021 BIANNUAL HCPCS CODING CYCLE

CMS is announcing the publication of its HCPCS Public Meeting Agendas for its July 7-9, 2021 Virtual HCPCS Public Meeting. The agendas are available at: https://www.cms.gov/Medicare/Coding/MedHCPCSGenInfo/HCPCSPublicMeetings

CMS notes that although we have announced that the virtual public meeting will be held over a period of three days, we have arranged the preliminary coding recommendations we intend to discuss over a period of two days; July 7 and 8. If we receive a greater number of speaker registrations than we believe we can reasonably accommodate over those two days, we reserve the right to shift some agenda items to a third day, July 9. In that eventuality, we would make every effort to notify all affected speakers as soon as possible, in addition to posting all updates on CMS’ HCPCS website at: https://www.cms.gov/Medicare/Coding/MedHCPCSGenInfo/HCPCSPublicMeetings.

CMS also reminds interested parties about the “Guidelines for Participation in Virtual Public Meetings in July 2021 for New Revisions to the Healthcare Common Procedure Coding System (HCPCS) Code Set.” These guidelines can be viewed and downloaded at: https://www.cms.gov/Medicare/Coding/MedHCPCSGenInfo/HCPCSPublicMeetings

The guidelines contain important and useful information, such as instructions for registering to attend public meetings; instructions for registering as a primary speaker or a 5-minute speaker; deadlines for registration and materials submission; and tips for helping CMS conduct a productive meeting.

The deadline for the public meeting registration and primary speaker materials is Friday, June 25, 2021, at
5:00 p.m., e.d.t. All speakers must register online, identify as a primary or a 5-minute speaker, and provide the requested contact information at: 
https://cms.zoomgov.com/webinar/register/WN_ukTCxcctSReHO2RJaD5O6w

The Zoom link, for the July 7-9, 2021 public meeting is: https://cms.zoomgov.com/webinar/register/WN_ukTCxcctSReHO2RJaD5O6w.

PUBLICATION OF REVISED CMS HCPCS LEVEL II CODE DECISIONS FOR FIRST QUARTER (Q1), 2021 APPLICATION CYCLE FOR DRUGS AND BIOLOGICS

The 2021 HCPCS Application Summary for Q1 Cycle for Drugs and Biologics was updated on 05/26/2021 to reflect a correction to the code number previously published to identify Kcentra. The final, corrected code assignment is J7168, as specified in the FINAL DECISION for item 21.008 in the 2021 HCPCS Application Summary for Quarter 1, 2021 Drugs and Biologics document. Code number J7168 replaces code J7169, which was previously published in error.

The revised HCPCS Level II code decisions and application summary documents for First Quarterly Cycle for Drugs and Biologics may be downloaded at:

https://www.cms.gov/Medicare/Coding/MedHCPCSGenInfo/Prior-Years-CMS-HCPCS-LevelII-Coding-Decisions-Narrative-Summary

PUBLICATION OF CMS HCPCS LEVEL II CODE DECISIONS FOR FIRST QUARTER (Q1), 2021 APPLICATION CYCLE FOR DRUG AND BIOLOGICAL PRODUCTS

The Centers for Medicare & Medicaid Services (CMS) has updated its Healthcare Common Procedural Coding System (HCPCS) Level II coding procedures to enable shorter and more frequent HCPCS code application cycles. CMS has implemented quarterly HCPCS code application opportunities for drugs and biological products; and bi-annual application opportunities for durable medical equipment, orthotics, prosthetics and supplies, and other non-drug, non-biological products, as part of our comprehensive initiative to foster innovation and expedite adoption of and patient access to new medical technologies.

CMS is pleased to announce publication of its 2021 HCPCS Application Summary for Q1 Drugs and Biologicals at: https://www.cms.gov/Medicare/Coding/MedHCPCSGenInfo/Prior-Years-CMS-HCPCS-LevelII-Coding-Decisions-Narrative-Summary.

This narrative summary document includes a sequential listing of applications for HCPCS codes for drug and biological products submitted to CMS’ First Quarterly coding cycle of 2021 (Q1 2021).  For each application, the following information is provided: a statement of the incoming request; a summary of the applicant’s request; and CMS’ coding decision.

Please continue to monitor this web site for CMS July 2021 HCPCS Update file, which will be published separately, in the coming weeks, at: https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/Alpha-Numeric-HCPCS

PUBLICATION OF REVISED HCPCS LEVEL II CODE MODIFICATION APPLICATION FORM AND INSTRUCTIONS FOR 2021 CODING CYCLE AND HCPCS LEVEL II CODING PROCEDURES DOCUMENTS

CMS has revised its Healthcare Common Procedure Coding System (HCPCS) Level II Code Modification Application Form and Instructions document and HCPCS Level II Coding Procedures document to update the HCPCS Level II code application submission deadlines, contact information, and public meeting schedule for the upcoming 2021 coding cycles. 

PUBLICATION OF CMS HCPCS LEVEL II CODE DECISIONS FOR FOURTH QUARTER (Q4), 2020 APPLICATION CYCLE FOR DRUG AND BIOLOGICAL PRODUCTS AND SECOND BI-ANNUAL 2020 CODING CYCLE (B2), FOR NON-DRUG AND NON-BIOLOGICAL ITEMS AND SERVICES

The Centers for Medicare & Medicaid Services (CMS) is updating its Healthcare Common Procedural Coding System (HCPCS) Level II coding procedures to enable shorter and more frequent HCPCS code application cycles. CMS has implemented quarterly HCPCS code application opportunities for drugs and biological products; and bi-annual application opportunities for durable medical equipment, orthotics, prosthetics and supplies, and other non-drug, non-biological products, as part of our comprehensive initiative to foster innovation and expedite adoption of and patient access to new medical technologies.

CMS is pleased to announce publication of its 2020 HCPCS application summaries for Q4 drugs and biologicals and our second bi-annual 2020 coding cycle (B2) for non-drug and non-biological items and services at: https://www.cms.gov/Medicare/Coding/MedHCPCSGenInfo/Prior-Years-CMS-HCPCS-LevelII-Coding-Decisions-Narrative-Summary.

This narrative summary document includes a sequential listing of applications for HCPCS codes for drug and biological products submitted to CMS’ Fourth Quarterly coding cycle of 2020 (Q4 2020) and non-drug and non-biological items and services applications submitted to CMS’ second bi-annual coding cycle of 2020 (B2).  For each application for drug and biological products, the following information is provided: a statement of the incoming request, a summary of the applicant’s request, and CMS’ coding decision. For each application for non-drug and non-biological items and services, the following information is provided: a statement of the incoming request, a summary of the applicant’s request, a preliminary HCPCS coding recommendation, a summary of primary speaker comments at the public meeting, and CMS’ coding decision.

Please continue to monitor this web site for CMS April 2021 HCPCS Update file, which will be published separately, in the coming weeks, at: https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/Alpha-Numeric-HCPCS.

CMS is announcing publication of its HCPCS Public Meeting Agendas for its December 21 and December 22, 2020 Virtual HCPCS Public Meetings for Non-Drug and Non-Biological Items and Services.   The agendas are available at https://www.cms.gov/Medicare/Coding/MedHCPCSGenInfo/HCPCSPublicMeetings

CMS is announcing the deadline for submission of new HCPCS code applications:

The deadline for submission of new HCPCS code applications for 2021 1st quarterly cycle for Drugs and Biologicals is January 4, 2021.

The deadline for submission of new HCPCS code applications for 2021 1st bi-annual cycle for DMEPOS and Other Non-Drug, Non-Biological Coding Cycles is January 4, 2021.

The deadline for submission of new HCPCS code applications for 2021 2nd quarterly cycle for Drugs and Biologicals is April 1, 2021.

Due to the COVID-19 Public Health Emergency and related restrictions on public gatherings, the December 2020 HCPCS Public Meetings will be held virtually via Zoom for remote attendance only.

Note that during the December 22, 2020, Public Meeting, in addition to information pertaining to current applications for DMEPOS and other non-drug and non-biological items, CMS is also including information pertaining to the establishment of three new codes K1010 (Indwelling intraurethral drainage device with valve, replacement only, each), K1011 (Activation device for intraurethral drainage device with valve, replacement only, each), and K1012 (Charger and base station for intraurethral activation device, replacement only).   We are interested in gathering additional input pertaining to use of these codes.  Please refer to the December 22, 2020 HCPCS Public Meeting agenda for additional information.

CMS also reminds interested parties about the “2020 Guidelines for Participation in Virtual Public Meetings for New Public Requests for Revisions to the Healthcare Common Procedure Coding System (HCPCS)”.  These guidelines can be viewed and downloaded at https://www.cms.gov/Medicare/Coding/MedHCPCSGenInfo/HCPCSPublicMeetings

These guidelines contain important and useful information such as instructions for registering to attend public meetings; instructions for registering as a primary speaker or a 5-minute speaker; guidelines for participation in public meetings; deadlines for registration and materials submission; and tips for helping CMS conduct a productive meeting.

The deadline for the public meeting registration and primary speaker materials is December 17, 2020, at 5 pm ET.

All speakers must register online, identify as a primary or 5-minute speaker, and provide the requested contact information at https://www.cms.gov/events.  Registration is necessary in order for speakers to receive their participant ID.   

The Zoom link, for December 21 and December 22, 2020 public meetings: https://cms.zoomgov.com/j/1610701817?pwd=R3hYaWtPaGVVREh2YVNMSkFQMThEQT09.

 


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.

Page Last Modified:
06/14/2021 10:42 AM