How CMS Updates HCPCS Codes Quarterly

CMS maintains the HCPCS Level II code set on a quarterly update cycle. Changes take effect on January 1, April 1, July 1, and October 1 of each year. The January update is typically the largest, coinciding with the annual physician fee schedule update. Interim updates may include new J-codes for newly approved drugs, temporary codes for new procedures, and deletions of discontinued items. Review the quarterly changes log to see what changed each cycle.

The quarterly update process starts well before the effective date. CMS typically releases the updated code files — including the HCPCS code descriptor file and the accompanying payment data — several weeks in advance. This gives providers, billing system vendors, and payers time to update their systems. Providers who fail to update their charge capture systems in time may use deleted codes or miss new codes entirely, leading to preventable denials.

New codes are typically added to accommodate newly FDA-approved drugs, newly approved procedures, or policy changes that create a need for distinct reporting. Revisions to existing codes may tighten or expand the description of what the code covers. Deletions occur when a drug or service is discontinued, when a temporary code is replaced by a permanent one, or when CMS determines a separate code is no longer needed.

Billing teams should build a quarterly review into their calendar. At minimum, compare the deleted code list against your chargemaster and any codes you actively bill. Check the revised codes against your current descriptions. Add new codes that are relevant to your specialty or service line. The quarterly changes pages on this site show added, revised, and deleted codes by quarter.