Who is responsible for maintaining HCPCS codes?

The correct response identifies the Centers for Medicare and Medicaid Services (CMS) as the entity responsible for maintaining HCPCS (Healthcare Common Procedure Coding System) codes. CMS oversees the HCPCS Level II coding system, which includes codes for products, supplies, and non-physician services that are not included in the CPT (Current Procedural Terminology) codes maintained by the American Medical Association (AMA).

CMS’s role is critical in ensuring that the coding system reflects current medical services, supplies, and technologies, thereby playing a foundational role in the billing and reimbursement processes for healthcare services provided to Medicare and Medicaid beneficiaries. This responsibility ensures that the coding system is updated to meet the evolving landscape of medical practice and healthcare delivery.

While the AMA does manage the CPT codes, which are predominantly used for physician services, HCPCS Level I codes are essentially the same as CPT codes, and the AMA does not handle HCPCS Level II codes, which are specifically maintained by CMS. Therefore, recognizing CMS’s stewardship over HCPCS codes clarifies the organizational responsibilities within the healthcare coding framework.