US · guidance
CMS Pub. 100-04, ch. 23, § 20
Description of Healthcare Common Procedure Coding System (HCPCS)
The HCPCS has been adopted as the code set for use in Health Insurance Portability and Accountability Act
(HIPAA) transactions, for reporting outpatient procedures, items, and services.
The HCPCS originated from the American Medical Association’s (AMA) “Physicians’ Current Procedural
Terminology, Fourth Edition” (CPT-4). It includes two levels of codes and modifiers. Level I contains only
the AMA’s CPT-4 codes. This level consists of all numeric codes. Level II contains alpha-numeric codes
primarily for items and nonphysician services not included in CPT-4, e.g., ambulance, DME, orthotics, and
prosthetics. These are alpha-numeric codes maintained by CMS.
The CMS monitors the system to ensure uniformity.
History
(Rev. 10320, Issued: 08-28-2020, Effective: 12-01-2020, Implementation: 12-01-2020)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
03aa59951c8285c73de64486e2d150b5eb9637917d6aaa5227912417f77d42ea
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