What is HCPCS used for?
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The Healthcare Common Procedure Coding System (HCPCS) is used in the United States to standardize the coding of medical services, procedures, and equipment for billing and documentation purposes. Developed by the Centers for Medicare & Medicaid Services (CMS), HCPCS ensures that healthcare providers, insurers, and government programs like Medicare and Medicaid use consistent codes when processing claims.
HCPCS is divided into two levels. Level I consists of the American Medical Association’s Current Procedural Terminology (CPT) codes, which cover medical procedures and services performed by healthcare professionals. Level II codes, maintained by CMS, cover non-physician services such as ambulance rides, durable medical equipment (DME), prosthetics, orthotics, and supplies not included in CPT codes.
HCPCS plays a vital role in healthcare administration by facilitating efficient claims processing, enabling accurate reimbursement, and supporting data collection for policy and research. Providers use these codes when submitting claims to Medicare, Medicaid, and other insurers to ensure proper payment for services rendered. The standardized system also helps prevent fraud, improve auditing, and enhance the quality of patient care through consistent documentation.
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