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 designated health services (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.
Beginning with the Code List effective January 1, 2023, updates are published solely on this webpage. On or before December 2nd of each year, we will publish the annual update to the Code List and provide a 30-day public comment period using www.regulations.gov. To be considered, comments must be received within the stated 30-day timeframe. We anticipate that most comments will be addressed by April 1st; however, a longer timeframe may be necessary to address complex comments or those that require coordination with external parties. If no comments are received, in lieu of a comment response, we will publish a note below the applicable Code List year stating so.
2023 Annual Update to the Code List
Below you will find the Code List that is effective January 1, 2023 and a description of the revisions effective for Calendar Year 2023. To submit a comment, go to www.regulations.gov and enter the docket number “CMS-2022-0152” in the search field. Select the “Comment” button and follow the instructions. To be considered, comments must be received on or before December 30, 2022.
- List of codes effective January 1, 2023, published December 1, 2022
- Annual Update to the List of CPT/HCPCS Codes Effective January 1, 2023, published December 1, 2022
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))