HCPCS Codes Explained
Healthcare Common Procedure Coding System codes for medical procedures and services. Understand what each code means on your medical bills.
We can only show HCPCS Level II codes with A-V prefixes due to expensive AMA licensing restrictions.Learn more about these restrictions →
Showing 25 of 125 HCPCS codes
G0152Occupational therapy services provided in your home, billed per 15-minute session
This code represents occupational therapy services delivered by a qualified occupational therapist in your home through a home health agency or hospice program. Each unit of this code covers 15 minutes of direct therapy time. Occupational therapy focuses on helping you perform daily activities and improve your ability to function independently at home. The therapist works with you on skills like dressing, bathing, cooking, or using adaptive equipment to make daily tasks easier and safer.
G8988Tracking of self-care ability goals during therapy treatment
This code is used by healthcare providers to document and track your progress toward self-care goals during therapy episodes. Self-care refers to your ability to perform daily activities like bathing, dressing, eating, and personal hygiene independently. The code captures your projected goals at the start of therapy, progress updates during treatment intervals, and final status when therapy ends or reporting concludes. This helps therapists measure how well therapy is helping you become more independent in taking care of yourself.
A7031Replacement face mask interface for full face mask
This code represents a replacement component for a full face mask - specifically the interface part that connects to your face. This is a replacement piece for medical equipment that covers both your nose and mouth, commonly used with breathing assistance devices like CPAP machines or ventilators. The interface is the part that creates the seal against your face and may need periodic replacement due to wear or for hygiene purposes.
A7046Replacement water chamber for CPAP/BiPAP humidifier
This code covers a replacement water chamber (tank) that is part of a humidifier system used with positive airway pressure devices like CPAP or BiPAP machines. The water chamber holds water that gets heated to add moisture to the air you breathe through your sleep apnea device, making therapy more comfortable. This is a single replacement part that needs to be changed periodically for hygiene and proper function.
G1004Clinical decision support system from a national company
This code represents a clinical decision support mechanism provided by a national decision support company, as defined by Medicare's appropriate use criteria program. Clinical decision support systems are computer-based tools that help healthcare providers make better treatment decisions by providing evidence-based recommendations and guidelines at the point of care.
J2704Injection of propofol, 10 mg dose
This code represents a 10 milligram injection of propofol, which is a medication commonly used for anesthesia and sedation during medical procedures. The code is used for billing purposes to track the specific amount of this medication administered to a patient.
G0444Annual depression screening visit lasting 5-15 minutes
This code represents a yearly screening appointment specifically designed to check for signs of depression. During this 5 to 15 minute visit, a healthcare provider will ask you questions or have you complete a questionnaire to assess your mental health and identify any symptoms of depression. This is a preventive care service meant to catch depression early, even if you haven't reported feeling depressed.
G0467Visit to a Federally Qualified Health Center for an established patient
This code represents a face-to-face medical visit at a Federally Qualified Health Center (FQHC) for a patient who has been seen there before. FQHCs are community-based healthcare providers that receive federal funding to provide primary care services in underserved areas. This visit includes a one-on-one encounter between you and a healthcare practitioner where medical services are provided. The code covers a bundle of typical Medicare-covered services that would be provided during your visit to the FQHC.
G0446Annual face-to-face behavioral therapy session for heart disease prevention (15 minutes)
This code represents a 15-minute, one-on-one counseling session with a healthcare provider focused on behavioral therapy for cardiovascular (heart) disease prevention. This is an annual service where the provider works with you individually to discuss and develop strategies for heart-healthy behaviors such as diet, exercise, smoking cessation, and stress management. The session must be conducted in person (face-to-face) and is specifically designed to help prevent or manage cardiovascular disease through behavioral interventions.
A7038Disposable filter for positive airway pressure (PAP) devices
This code represents a disposable filter that is used with positive airway pressure devices, such as CPAP or BiPAP machines. These filters help keep the air clean by removing dust, pollen, and other particles from the air that flows through your sleep apnea or breathing assistance device. The filter needs to be replaced regularly to maintain proper function and hygiene of your PAP equipment.
P9604Travel fee for one-way trip to collect lab samples from homebound patients
This code represents a travel allowance fee that covers the cost of a healthcare worker making a one-way trip to collect laboratory specimens from patients who are confined to their home or nursing home. The fee is prorated, meaning it's calculated based on the actual distance or time required for the trip. This service is only used when the lab sample collection is medically necessary and the patient cannot travel to a medical facility.
G0299Registered nurse care services in your home or hospice, billed per 15-minute period
This code represents direct skilled nursing care provided by a registered nurse (RN) in either a home health or hospice care setting. The service is measured and billed in 15-minute increments. This includes hands-on nursing care, medical assessments, medication management, wound care, patient education, and other skilled nursing interventions that can only be performed by a licensed registered nurse. The care is provided in your home or at a hospice facility rather than in a hospital or clinic setting.
G0300Licensed practical nurse (LPN) care in home or hospice setting, billed per 15-minute period
This code represents direct skilled nursing services provided by a licensed practical nurse (LPN) in either a home health care or hospice care setting. The service is measured and billed in 15-minute increments. LPNs provide nursing care under the supervision of registered nurses or physicians, which may include medication administration, wound care, monitoring vital signs, and other skilled nursing tasks as part of your home-based or hospice care plan.
J3301Injection of triamcinolone acetonide, 10 mg dose
This code represents a 10 mg injection of triamcinolone acetonide, a corticosteroid medication. The 'not otherwise specified' designation means this code is used when the specific brand or formulation of triamcinolone acetonide isn't identified by other more specific codes. Triamcinolone acetonide is an anti-inflammatory steroid medication that can be injected into joints, muscles, or other body areas to reduce inflammation and pain.
G0463Hospital outpatient clinic visit for patient assessment and management
This code represents a visit to a hospital's outpatient clinic where a healthcare provider evaluates and manages a patient's medical condition. This type of visit occurs when you receive care at a hospital-based clinic but are not admitted as an inpatient. The provider will assess your health status, review symptoms, and develop or adjust your treatment plan during this appointment.
G0439Follow-up annual wellness visit with personalized prevention plan
This code represents a subsequent (follow-up) annual wellness visit that includes creating or updating a personalized prevention plan of service (PPS). This is typically the second or later annual wellness visit, building on your previous wellness visit. During this visit, your healthcare provider will review your health status, update your personalized prevention plan based on your current health risks and needs, and discuss preventive care services that may be appropriate for you.
G0179Doctor's review and approval to continue home health services
This code represents when a doctor or qualified healthcare provider reviews and re-certifies that a patient should continue receiving Medicare-covered home health services. The doctor reviews reports about the patient's condition and progress from the home health agency, then confirms that ongoing home health care is still medically necessary. This review happens without the patient being present and is required by Medicare to ensure continued coverage of home health services.
G0442Annual alcohol screening appointment (5-15 minutes)
This code represents an annual screening appointment to assess alcohol use patterns and identify potential alcohol misuse. The screening typically involves questions about drinking habits and takes between 5 to 15 minutes to complete. This is a preventive health service designed to identify alcohol-related concerns early and provide appropriate guidance or referrals if needed.
Q5001Hospice or home health care services provided in your home or residence
This code represents hospice care or home health services that are delivered directly in your home or place of residence. This allows you to receive professional medical care, comfort care, or end-of-life services in the familiar environment of your own home rather than in a hospital or facility setting.
J0696Ceftriaxone sodium antibiotic injection, billed per 250 mg dose
This code represents billing for ceftriaxone sodium, a powerful antibiotic medication given by injection (either into a vein or muscle). The code covers each 250 mg portion of the medication administered. Ceftriaxone is a broad-spectrum antibiotic used to treat various bacterial infections. This is specifically the billing code for the medication itself, not the administration procedure.
G8783Documentation of normal blood pressure reading with no follow-up needed
This code is used when a healthcare provider documents that a patient's blood pressure reading was normal and within healthy ranges, and therefore no additional follow-up appointments or monitoring are required at this time. This represents a positive health outcome where the blood pressure screening showed results that don't require further medical attention or intervention.
A9270Non-covered item or service
This code indicates that a particular medical item or service is not covered by your insurance plan or Medicare/Medicaid. When this code appears on your medical bill or claim, it means the insurance company has determined that the specific treatment, procedure, equipment, or service does not qualify for coverage under your current benefits. You may be responsible for paying the full cost of this item or service out-of-pocket.
A7034Nasal mask or tube device for sleep apnea machines
This is a nasal interface device that connects to a positive airway pressure (PAP) machine, commonly used for treating sleep apnea. It can be either a nasal mask that covers the nose or nasal cannula (small tubes that go in the nostrils). The device may include a head strap to keep it in place during sleep. This interface allows the PAP machine to deliver pressurized air through your nose to keep your airway open while you sleep.
G0180Doctor's certification for Medicare home health services
This code represents when a doctor or qualified healthcare provider officially certifies that a patient needs Medicare-covered home health services. The doctor reviews the patient's home health plan of care, communicates with the home health agency, and reviews status reports to confirm the patient qualifies for these services. This certification process happens without the patient being present during the doctor's review and approval process.
G8417Documentation that BMI is above normal range with follow-up plan recorded
This code indicates that a healthcare provider has calculated and documented that a patient's Body Mass Index (BMI) is above normal parameters (typically meaning overweight or obese range) and has also documented a specific follow-up plan to address this finding. BMI is a measurement that uses height and weight to estimate body fat and assess weight categories. This code represents the administrative tracking of proper documentation practices rather than a specific medical procedure or treatment.
Need Help Understanding Your Medical Bills?
Get personalized assistance with all the medical codes on your bills. Our experts can help you understand what each code means and how it affects your costs.