HCPCS Level II
The CMS-maintained code set covering products, supplies, and services not included in CPT — primarily durable medical equipment, drugs, and Medicare-specific services.
1 min read · Last reviewed May 23, 2026
At a glance
- Category
- Billing
- Primary sources
- 2
- Workspace handoff
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Where this comes up
This shows up in revenue-cycle work — claim scrubbing, charge entry, posting, A/R follow-up, and month-end close. Billers and practice managers hit this term when reconciling a payment, working a denial queue, or auditing why a claim aged past 60 days.
Full definition
What it is in practice
HCPCS Level II covers DME, prosthetics, J-codes (drugs), G-codes (Medicare temporary procedures), and a long tail of administrative codes. CMS updates the set quarterly.
How it shows up in your practice
Most physician practices bill HCPCS for vaccines, injectables, and Medicare-only services like G2211. The biller needs both CPT and HCPCS reference tables.
Sources
- CMS — Physician Fee Schedule (PFS)https://www.cms.gov/medicare/payment/fee-schedules/physician
- AMA — Current Procedural Terminology (CPT)https://www.ama-assn.org/practice-management/cpt
Look up HCPCS codes in Ask D3
Open ask d3 →Related terms
- BillingCPT (Current Procedural Terminology)The AMA-maintained code set that describes medical, surgical, and diagnostic services for billing.
- BillingG2211 (Visit Complexity Add-on)Medicare HCPCS add-on code recognizing the visit complexity inherent to evaluation and management services associated with primary care and certain longitudinal care.
- BillingJ-CodeHCPCS Level II codes (J0000-J9999) used to bill drugs administered other than by oral method.
- BillingG-CodeHCPCS Level II codes (G0000-G9999) for procedures and services that do not have CPT codes — primarily Medicare temporary or Medicare-specific services.
D3rx is a healthcare-billing and compliance research aid maintained by D3rx Inc. Articles are drafted by an LLM (Anthropic Claude) against primary HHS, OCR, CMS, eCFR, NIST, and state-regulator publications, and reviewed for restraint and source fidelity by the D3rx team.
Reviewer status: a named credentialed reviewer (CHC, CHPC, or healthcare attorney) is being engaged. Until that engagement is finalized, this page does not claim credentialed review.
Related across the archive
- GlossaryCPT (Current Procedural Terminology)The AMA-maintained code set that describes medical, surgical, and diagnostic services for billing.
- GlossaryG-CodeHCPCS Level II codes (G0000-G9999) for procedures and services that do not have CPT codes — primarily Medicare temporary or Medicare-specific services.
- GlossaryG2211 (Visit Complexity Add-on)Medicare HCPCS add-on code recognizing the visit complexity inherent to evaluation and management services associated with primary care and certain longitudinal care.
- GlossaryJ-CodeHCPCS Level II codes (J0000-J9999) used to bill drugs administered other than by oral method.
- GlossaryCardiac Stress Test (93015-93018)CPT codes for cardiac stress testing, with separate codes for the global service, supervision, and interpretation.
- GlossaryCharge CaptureThe process of identifying and recording every billable service furnished during a patient encounter.
- GlossaryClean Claim RatePercentage of claims accepted by the payer on first submission without edits or rejections.
- BillingAWV + Problem Visit Same Day: How to Bill CorrectlyYes, you can bill AWV and a problem visit the same day. Here's how to do it correctly with modifier -25.
This glossary entry is a research aid for billing and compliance staff. It does not provide legal, medical, or financial advice and does not replace counsel. References cited link to primary sources at HHS, OCR, CMS, eCFR, NIST, and the relevant payer or industry body.