CMS HCPCS Coding Questions
Guidance for coding questions for Healthcare Common procedure Coding System (HCPCS) level I and level II.
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: February 11, 2020
HCPCS Level I
Contact the AMA for issues related to the application of HCPCS Level I Current Procedural Terminology (CPT®) codes.
HCPCS Level II
- To contact CMS, email hcpcs@cms.hhs.gov
- For any billing or coding issues, refer to the insurer(s) in whose jurisdiction(s) the claim would be filed.
- For Medicare, please contact the Medicare Administrative Contractor (MAC) in whose jurisdiction the claim would be filed.
- For Medicaid, contact the Medicaid Agency in the state in which the claim would be filed.
- For private insurance, contact the individual private insurance entity.
- For coding questions about existing HCPCS Level II codes related to non-drug and non-biological products (for example, durable medical equipment, prosthetics, orthotics, and other supplies), contact the Pricing, Coding Analysis, and Coding (PDAC) Medicare contractor.
- The PDAC helps suppliers and manufacturers determine which existing HCPCS Level II code should be used to describe non-drug and non-biological items for Medicare billing.
- The PDAC has a Durable Medical Equipment Coding System (DMECS) where you can search for HCPCS Level II details and Medicare fees, modifier details, product ifications, and more.
- For coding questions about 505(b)(2) approved drugs or biologicals, review the Frequently Asked Questions for Single Source Drugs and Biologicals (PDF).
- For questions related to Average Sales Price (ASP) HCPCS-National Drug Code (NDC) crosswalk for drugs, email Sec303ASPdata@cms.hhs.gov
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