--- title: "HCPCS, HCPCS Codes | MedTech Terms" description: "CMS-maintained codes for products, supplies, and services not in CPT. 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[Home](/) 2. / 3. [Terms](/terms) 4. / 5. [Reimbursement](/terms?cat=Reimbursement) 6. / 7. HCPCS Codes [All terms](/terms) Reimbursement [Hospital Buyer & Reimbursement](/ecosystems/hospital-buyer)HCPCS # HCPCS Codes CMS-maintained codes for products, supplies, and services not in CPT. Reviewed by [Christian Espinosa, Founder, Blue Goat Cyber](/authors/christian-espinosa) Last reviewed May 5, 2026 ## Definition Healthcare Common Procedure Coding System Level II codes describe products, supplies, drugs, and services not included in [CPT](/terms/cpt-codes) - durable medical equipment, prosthetics, orthotics, supplies ( [DMEPOS](/terms/dmepos)), and physician-administered drugs (J-codes). What the regulation says HCPCS codes are maintained by the Centers for Medicare & Medicaid Services (CMS) and are essential for billing medical devices and services to Medicare, Medicaid, and other insurers. While not directly a regulatory requirement for medical device approval, accurate HCPCS coding is crucial for market access and reimbursement in the United States, as outlined in CMS guidance. ## What this means in practice DME, supplies, and many home-use medical devices are billed under HCPCS. Code assignment, coverage, and pricing are coordinated through CMS quarterly and annual updates. ## Examples - A manufacturer of a new type of wound dressing must identify the appropriate HCPCS code to ensure their product can be billed to Medicare beneficiaries. - A MedTech company developing a novel home-use diagnostic device needs to obtain a specific HCPCS code or ensure their device fits an existing code for reimbursement. - A provider billing for a physician-administered drug, a J-code, uses HCPCS codes to get reimbursement from health insurance payers. Common pitfalls - • Misinterpreting HCPCS code descriptions can lead to claim denials and payment delays. - • Failing to regularly check CMS updates for HCPCS codes can result in using outdated or incorrect codes. - • Assuming a HCPCS code guarantees reimbursement without verifying coverage policies of specific payers is a common mistake. - • Coding medical devices with generic HCPCS codes when more specific, product-specific codes exist can lead to lower reimbursement or scrutiny. - • Not understanding the difference between HCPCS Level I (CPT) and Level II codes can result in incorrect billing practices. ## Frequently asked questions What is the primary purpose of HCPCS Level II codes? HCPCS Level II codes primarily describe products, supplies, drugs, and services not included in [CPT codes](/terms/cpt-codes), such as durable medical equipment, prosthetics, orthotics, and physician-administered drugs. Who is responsible for maintaining HCPCS codes? How do HCPCS codes impact market access for MedTech companies? ## Cross-references ### See also Closely related context worth reading. - [ Current Procedural Terminology Codes(CPT) ](/terms/cpt) ## Related terms Grouped by theme ### Editor's picks · Hand-selected related concepts [ Reimbursement CPT Codes(CPT) AMA-maintained codes that describe medical procedures and services. ](/terms/cpt-codes) ### Reimbursement & Market Access · From this learning path [ Reimbursement ICD-10-CM / ICD-10-PCS Diagnosis (CM) and inpatient procedure (PCS) coding systems used in U.S. claims. Adjacent lesson ](/terms/icd-10?from=reimbursement-and-market-access)[ Reimbursement Budget Impact Model(BIM) Financial model that estimates the total cost consequences of adopting a new technology to a payer's budget over a defined horizon. ](/terms/budget-impact-model?from=reimbursement-and-market-access)[ Reimbursement Current Procedural Terminology Codes(CPT) AMA-maintained codes used to report medical procedures and services for billing. ](/terms/cpt?from=reimbursement-and-market-access)[ Reimbursement Health Technology Assessment(HTA) Systematic evaluation of clinical and economic value of a health technology. ](/terms/hta?from=reimbursement-and-market-access) ### More in Reimbursement · Same category [ Reimbursement LCD and NCD Local and National Coverage Determinations from Medicare. ](/terms/lcd-ncd)[ Reimbursement Medicare Administrative Contractor(MAC) Private contractors that process Medicare Part A/B and DME claims and issue Local Coverage Determinations within their jurisdictions. ](/terms/mac)[ Reimbursement National and Local Coverage Determinations(NCD / LCD) Medicare coverage policies issued nationally (NCD) or by individual MAC contractors (LCD). ](/terms/ncd-lcd) Cited by Where this term appears across MedTech Terms. Learning paths (1) - [Reimbursement & Market Access](/paths/reimbursement-and-market-access)Lesson 3 of 14 Ecosystems (1) - [Hospital Buyer & Reimbursement](/ecosystems/hospital-buyer) ## Primary references 3 sources Link health: 3 verified · last checked 2026-06-20 CMS· 1 AdvaMed· 1 AMA· 1 1. [1 CMS HCPCS Verified CMS · cms.gov ](https://www.cms.gov/medicare/coding/medhcpcsgeninfo) 2. [2 AdvaMed - Payment & Coverage Verified AdvaMed · advamed.org ](https://www.advamed.org/our-work/) 3. [3 AMA CPT Resources Verified AMA · ama-assn.org ](https://www.ama-assn.org/practice-management/cpt) Inline markers like \[1\] jump to the matching reference above. Sponsor note ### Need cybersecurity expertise on a connected-device launch? Blue Goat Cyber helps MedTech teams ship connected products that hospital security teams will actually procure. [Book a 30-minute discovery session](https://go.bluegoatcyber.com/meetings/blue-goat-cyber/discovery-session) - No obligation - Expert-led from minute one - NDA available on request MedTech Terms is a community resource sponsored by [Blue Goat Cyber](https://bluegoatcyber.com). Definitions are independent of any vendor. On this term Category Reimbursement Acronym HCPCS Sources 3 Updated 5/5/2026 [Compare with another term](/compare?a=hcpcs) Learn in 60 seconds Card Lesson Quiz CMS-maintained codes for products, supplies, and services not in CPT. - · DME, supplies, and many home-use medical devices are billed under HCPCS. - · Code assignment, coverage, and pricing are coordinated through CMS quarterly and annual updates. Remember this Watch out: Misinterpreting HCPCS code descriptions can lead to claim denials and payment delays. Related terms - [CPT Codes(CPT) ](/terms/cpt-codes) You may also need Auto-suggested from Reimbursement and shared keywords. - [Durable Medical Equipment, Prosthetics, Orthotics, and Supplies(DMEPOS) ](/terms/dmepos) - [ICD-10-CM / ICD-10-PCS ](/terms/icd-10) - [Current Procedural Terminology Codes(CPT) ](/terms/cpt) - [Prior Authorization ](/terms/prior-authorization) - [340B Drug Pricing Program(340B) ](/terms/340b) - [Category III CPT Code ](/terms/category-iii-cpt) [All Reimbursement terms](/terms?cat=Reimbursement) MedTech Terms An authoritative, plain-language reference for the regulatory, quality, cybersecurity, and software terms that shape modern medical devices. 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