CMS Alpha-numeric HCPCS
Description
These files contain the Level II alphanumeric HCPCS procedure and modifier codes, their long and short descriptions, and applicable Medicare administrative, coverage and pricing data. See list below.
More about HCPCS
Healthcare Common Procedure Coding System (HCPCS) | CMS
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.
✋ Request this data source
Source Links
Download
HCPCS Quarterly Update | CMS
The official update of the HCPCS code system is available as a public use file below. Effective date is noted in the file title.January 2024 Alpha-Numeric HCPCS Files (ZIP) - Updated 12/07/2023
www.cms.gov
https://www.cms.gov/files/zip/july-2025-alpha-numeric-hcpcs-file.zip
- january
- april
- july
- october
https://www.cms.gov/files/zip/{month}-{year}-alpha-numeric-hcpcs-file.zip
Actual zip file downloaded is
hcpc2025_jul_anweb_v3
- jan
- apr
- jul
- oct
Other recent file names
hcpc{year}_{mon}_anweb…
See related use case:
RxNorm to complete NDC HCPCS walk · coderxio/sagerx · Discussion #245
Proposal CMS quarterly HCPCS does not contain all NDC available for a specific HCPCS code. Use RxNorm mapping to complete CMS mapping Rationale assessment of NDC level claims data will has potentia...
github.com
Update Frequency
As of 2020, only Quarterly.
Prior to that, full yearly update and quarterly incremental updates. Goes back to 2017.
Licensing
Table Info
2020 Alpha Numeric HCPCS File
2020 Corrections to the Alpha-Numeric HCPCS File
2020 HCPCS Index
2020 HCPCS NOC Codes
2020 HCPCS Record Layout
2020 HCPCS Table of Drugs
On this page
- CMS Alpha-numeric HCPCS
- Description
- Source Links
- Download
- Update Frequency
- Licensing
- Table Info