Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: September 17, 2020

Each year in the U.S., health care insurers process over 5 billion claims for payment. Standardized coding systems are essential so Medicare and other health insurance programs can process claims in an orderly and consistent manner. HCPCS is divided into 2 main subsystems — Level I and Level II.

HCPCS Level I: Comprised of Current Procedural Terminology (CPT®), a numeric coding system maintained by the American Medical Association (AMA). 

• CPT® is a uniform coding system consisting of descriptive terms and identifying codes used primarily to identify medical services and procedures furnished by physicians and other health care professionals for which they bill public or private health insurance programs.
• The AMA annually republishes and updates CPT® codes.
• CPT® codes consist of 5 numeric digits.
• Contact the AMA for issues related to the application of HCPCS Level I CPT® codes for physicians.

HCPCS Level II: A standardized coding system that is used primarily to identify products, supplies, and services not included in the CPT® codes, such as ambulance services or durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when used outside a physician's office.

• Medicare and other insurers cover a variety of services, supplies, and equipment that aren't identified by CPT® codes. The HCPCS Level II codes were established so providers and suppliers can submit claims for these items.
• HCPCS Level II codes (also known as alpha-numeric codes) consist of a single alphabetical letter followed by 4 numeric digits.
• CMS maintains HCPCS Level II codes, including decisions about additions, revisions, and deletions to the codes.
  • The HCPCS Level II coding system began in the 1980s.
  • In 2003, under 42 CFR 414.40(a), the HHS Secretary delegated authority to CMS to establish and maintain uniform national definitions of services, codes to represent services, and payment modifiers to the codes.
• For questions about HCPCS Level II, contact hcpcs@cms.hhs.gov.

Medicare Electronic Application Request Information System (MEARIS™)

Visit MEARIS™ to submit HCPCS Level II coding application.

• Anyone may submit a request to modify the HCPCS Level II national code set.
• Use the MEARIS™ electronic application to submit HCPCS Level II:
  • Quarterly drug and biological product applications.
  • Biannual non-drug and non-biological items and services applications.
• Application due dates:
  • Drug and biological products: The first business day of each quarter (January, April, July, and October)
  • Non-drug and non-biological items and services: The first business day of January and July

What's New

August 19, 2025

HCPCS Level II B1 2025 Non-Drug and Non-Biological Items & Services Final Determinations

CMS is delighted to announce that the final determinations for the Healthcare Common Procedure Coding System (HCPCS) Level II First Biannual 2025 Non-Drug and Non-Biological Items & Services coding cycle have been officially released.

To access the comprehensive document containing the finalized coding determinations for B1 2025, please click on the link below:

https://www.cms.gov/medicare/coding-billing/healthcare-common-procedure-system/current-prior-years-level-ii-coding-decisions

The publication covers a range of crucial updates, including new codes, revisions to existing codes etc. For each application, the following information is provided:

• a statement of the topic/issue;
• a summary of the applicant’s request;
• CMS’ preliminary coding determination;
• CMS’ preliminary Medicare benefit category determination;
• CMS’ preliminary Medicare payment determination;
• Summary of public feedback;
• CMS’ final HCPCS coding determinations;
• Final Medicare benefit category determination; and
• Final Medicare payment determination.

Please continue to monitor this web site for CMS’ October 2025 HCPCS Update file, which will be published separately in the coming weeks, at: https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/HCPCS-Quarterly-Update

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Sign up to our HCPCS Level II Updates Listserv to get the most current and accurate information about HCPCS Level II codes. Signing up is quick and easy!

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.