Medicare

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Billing Codes

cms.gov/medicare Code List for Certain Designated Health Services (DHS)

We maintain and annually update a List of Current Procedural Terminology (CPT) / Healthcare Common Procedure Coding System (HCPCS) Codes (Code List), which identifies all the items and services included within certain DHS categories. We update the Code List to conform the list to the most recent publications of CPT and HCPCS and to account for changes in Medicare coverage and payment policies. The updated Code List is published in the Federal Register as an addendum to the annual Physician Fee Schedule final rule. That rule is usually published in November and generally becomes effective January 1 of the following year. In addition, we may publish other rules or correction notices that may change the Code List. We post any changes to the Code List on this webpage as soon as possible after publication in the Federal Register.

NOTE: The following DHS categories are defined at 42 CFR §411.351 without reference to the Code List:

  • durable medical equipment and supplies;
  • parenteral and enteral nutrients, equipment and supplies;
  • prosthetics, orthotics, and prosthetic devices and supplies;
  • home health services;
  • outpatient prescription drugs; and
  • inpatient and outpatient hospital services.

govinfo.gov Content Details 42 CFR 411.351 - Definitions.

law.cornell.edu/cfr 42 CFR § 411.351 - Definitions.