HCPCS Level II code
HCPCS Level II is the standardized code set for products, supplies, and services not described by CPT — durable medical equipment, drugs, ambulance transport, and certain professional services.
Updated
HCPCS Level II (the Healthcare Common Procedure Coding System, Level II) is a code set maintained by CMS that describes medical equipment, supplies, drugs, and services that CPT does not cover. It includes durable medical equipment, orthotics and prosthetics, injectable and other drugs, ambulance services, and certain services furnished by non-physician professionals.
Where a CPT code reports a physician or clinical service, a HCPCS Level II code typically reports an item or a service outside that scope. Both appear on the same line of a professional claim, and a single encounter may carry codes from both sets.
In practice
HCPCS Level II is updated on a quarterly and annual cycle, and payers adopt updates on their own schedules. A code that was billable under the prior version may not be billable under the current one, so code selection must track the version the payer is applying.
Commonly confused with
- CPT code: CPT reports physician and clinical procedures (the AMA's code set); HCPCS Level II reports items and services CPT does not describe — equipment, supplies, and drugs.
- ICD-10-CM code: ICD-10-CM reports the diagnosis (why); HCPCS Level II reports the item or service furnished (what).