HCPCS Annual vs Quarterly Updates: What Changes

The HCPCS Level II code set is updated on a quarterly schedule — effective January 1, April 1, July 1, and October 1. The January update is the largest and coincides with the annual physician fee schedule update, so it typically contains the most code additions, deletions, and revisions. The interim quarters (April, July, October) tend to focus on new drug codes, temporary code additions, and minor revisions. Review the full history on the quarterly changes page.

Annual updates tend to affect the permanent sections of the code set — A-codes for supplies, E-codes for DME, L-codes for orthotics and prosthetics. These sections do not change as rapidly as drug codes, so most changes to these sections are bundled into the January update. Fee schedule rates for the physician, DMEPOS, and ASC schedules also take effect January 1 of each year.

Interim quarterly updates are driven primarily by drug availability. When a new biologic or specialty drug receives FDA approval and a Part B coverage determination, CMS assigns it a J-code that takes effect in the nearest quarterly update — sometimes as quickly as the following quarter. Billers serving oncology, infusion, or specialty pharmacy practices need to monitor interim quarterly updates closely, as new drugs may enter clinical use and require billing very soon after receiving a J-code.

Temporary codes — Q-codes, G-codes, and K-codes — may be added, revised, or deleted in any quarter as policy needs change. A temporary code that becomes permanent will be deleted from its temporary range and replaced by a permanent code. Billing teams should maintain a list of temporary codes in use and check whether any have been replaced each quarter. The quarterly changes log on this site separates added, revised, and deleted codes so you can scan the relevant section quickly.