CMS Implements Significant Updates to HCPCS Level II Coding Cycles and Procedures

Lexology December 16, 2019
Sidley Austin LLP

The Centers for Medicare & Medicaid Services (CMS) announced that, beginning in January 2020, CMS will implement shorter and more frequent coding cycles for requests to modify the Healthcare Common Procedure Coding System (HCPCS) Level II code set. Under the updated procedures, stakeholders will be able to submit code applications on a quarterly basis for drugs and biologicals, and on a bi-annual basis for durable medical equipment, orthotics, prosthetics and supplies (DMEPOS) and other non-drug, non-biological products. CMS also will publish final coding decisions more frequently, and has made additional process changes in light of the updated coding cycles. These updates represent a significant change from the prior framework that had only one submission deadline and coding cycle for each...

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