What is the difference between temporary HCPCS codes and permanent ones?

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HCPCS codes (Healthcare Common Procedure Coding System) are used to describe medical procedures, services, and products for billing purposes in the U.S. They come in two main types: temporary and permanent codes.

Temporary HCPCS Codes (Level II Temporary Codes)

• Purpose: Used for new, emerging, or experimental medical services, procedures, or items that do not yet have a permanent HCPCS code.

• Assignment: These codes are assigned by the Centers for Medicare & Medicaid Services (CMS) to track and bill for novel technologies or services while they are being evaluated.

• Format: Usually start with a letter (often “T”) followed by four numbers (e.g., T2023).

• Duration: Temporary codes are time-limited and typically valid for a few years, depending on CMS’s review process.

• Use: Allows providers to bill Medicare and other insurers for new services before a permanent code is established.

• Transition: After evaluation, if the service becomes standard, the temporary code may be replaced by a permanent HCPCS code or removed if it is discontinued.

Permanent HCPCS Codes (Level II Permanent Codes)

• Purpose: Represent established, widely used medical services, procedures, supplies, and equipment.

• Assignment: Also maintained by CMS and the American Medical Association (for CPT codes in Level I), permanent codes are updated annually.

• Format: Begin with a letter (A-V, excluding some letters) followed by four digits (e.g., A1234).

• Duration: Permanent codes remain stable unless updated or deleted during regular code set revisions.

• Use: Standard codes used for routine billing and documentation.

Summary:

Temporary HCPCS codes provide a way to bill for new or experimental services on a short-term basis, while permanent HCPCS codes are for established, routinely used procedures and items. Temporary codes bridge the gap until a permanent code can be assigned or the service is discontinued.

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