List of CPT/HCPCS Codes
We maintain and annually update a List of Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) Codes (the Code List), which identifies all the items and services included within certain DHS categories or that may qualify for certain exceptions. We update the Code List to conform to the most recent publications of CPT and HCPCS codes and to account for changes in Medicare coverage and payment policies. Code List updates for years 2022 and earlier were published in the Federal Register as an addendum to the annual Physician Fee Schedule final rule and posted on this webpage as soon as possible after publication in the Federal Register.
Beginning with the Code List effective January 1, 2023, we will publish updates solely on this webpage. No less than 30 consecutive calendar days prior to the effective date of a Code List update, we will provide advance notice of the updated Code List. We will also provide for a 30-day public comment period for each update using www.regulations.gov, and publish instructions for submitting comments on this webpage. We will address all public comments that we receive through this process on this webpage.
The DHS categories defined by the Code List are:
- clinical laboratory services;
- physical therapy services, occupational therapy services, outpatient speech-language pathology services;
- radiology and certain other imaging services; and
- radiation therapy services and supplies.
NOTE: The following DHS categories are defined at 42 CFR §411.351 without reference to the Code List:
- durable medical equipment and supplies;
- parenteral and enteral nutrients, equipment and supplies;
- prosthetics, orthotics, and prosthetic devices and supplies;
- home health services;
- outpatient prescription drugs; and
- inpatient and outpatient hospital services.
The exceptions that are defined by the Code List are:
- EPO and other dialysis-related drugs (42 CFR § 411.355(g))
- Preventive screening tests and vaccines (42 CFR § 411.355(h))