HCPCS

What is HCPCS?

HCPCS stands for Health Care Common Procedure Coding System. The HCPCS is a standardized coding system that is used to bill Medicare providers. HCPCS provides a common, uniform language and ensures that health care claims are processed in an orderly and consistent manner.

HCPCS codes are based on Current Procedural Technology (CPT) codes and developed by the American Medical Association. HCPCS Codes are numbers assigned to every task and service that a medical practitioner provides to a Medicare patient. These services can include medical, surgical and diagnostic procedures.

Examples Of HCPCS

Some examples of HCPCS codes include:

  • A4216 – represents “saline”
  • 90658 – indicates a flu shot
  • 99214 – stands for “may be used for a physical”

HCPCS Level I & HCPCS Level II

There are two sets of HCPCS codes. The first set, HCPCS Level I, are based on and identical to CPT codes. The second set, HCPCS Level II, are codes used by medical suppliers other than physicians, such as ambulance services or durable medical equipment. Level II HCPCS codes are costs that are not typically passed through a physician’s office, so they are handled differently by Medicare or Medicaid.

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