What are HCPCS Codes?

The Healthcare Common Procedure Coding System (HCPCS) is the system of universal medical codes used by Medicare to document the treatments and medical services performed by doctors. The purpose of the HCPCS coding system is to make treatment information universal, so it can be processed fairly and accurately by insurance companies.

The HCPCS code system is based on the CPT coding system, but is used for Medicare and Medicade, and maintained by the Centers for Medicare and Medicaid Services (CMS), whereas CPT codes are maintained by the American Medical Association (AMA).

HCPCS codes are divided into Level I codes and Level II codes.

Level I HCPCS Codes

Level I codes are identical to the CPT coding system, using a unique numerical or alphanumerical code for every medical treatment and service performed by medical professionals in hospitals, physician practices and other patient care centers. These codes are further divided into systems for established treatments, experimental treatments, and for the tracking of treatment effectiveness. For more information on these codes, refer to the CPT coding system.

Level II HCPCS Codes

These codes are similar in nature to Level I codes, but are used for medical purposes other than common medical practices covered by Level I, such as ambulance services and prosthetic devices. Level II codes are universal nationwide, but since Medicare and Medicaid are handled at the state level, the reimbursement for each code varies from state to state. Codes in Level II are composed of a letter from A to V, followed by a four-digit number.