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Background

CMS HCPCS (Levels I and II) Overview

What are the levels of HCPCS codes?
There are two principal subsystems, Level I and Level II.

Level I contains the American Medical Association (AMA) Physicians’ CPT.  CPT includes nearly 8,000 five-digit codes, each assigned to a short and long description of a service or procedure.  It is a system of documenting services performed by physicians and other healthcare professionals.  Professionals use the CPT to bill public or private health insurance programs and to track charges for services internally.  Level I does not include codes needed to bill for medical items or services that are billed by suppliers other than physicians, physical therapists, nurse practitioners, or other professionals.

Level II consists of the HCPCS, a standardized coding system used to identify products, supplies, and services not included in the CPT codes.  These codes begin with a single letter, followed by 4 numeric digits. For each Level II code, there is a descriptive terminology that identifies a category of like items. Currently, there are over 4,000 separate categories of like items or services that encompass millions of products from different manufactures. To avoid any appearance of endorsement of a particular product, brand or trade names are not represented by a code. The exception is codes that describe drugs and certain solutions.

Coding Systems