HCPCS Guidelines

The Healthcare Common Procedure Coding System (HCPCS) refers to a standardized coding system used by Medicare and other health insurance programs to identify medical procedures, equipment and services. The HCPCS contains two subsystems: Level I and Level II.

Level I

• Level I codes identify medical procedures and services. This system is also called Current Procedural Terminology and is defined and revised by the American Medical Association. Level I codes are composed of five numbers.

Level II

• Level II codes identify medical supplies and products, such as prosthetics, ambulance services or orthotics. Level II codes contain one letter and four numbers.

Considerations

• Level III codes, also called local codes, are codes developed by private insurers and state Medicaid programs to identify services or products that did not have a Level I or II code. These codes were eliminated on December 31, 2003.