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  • Dataset id: cms_hcpcs_codes
  • Jurisdiction: US · CMS
  • Date field: none. A search that sets date_from or date_to skips this dataset and reports it as skipped.
  • Access: any API key.

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Filters

Send these under filters.cms_hcpcs_codes in a search request. A filter not listed here, or a value of the wrong type, is a 400.
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string
Exact HCPCS Level II code, uppercase (e.g. “J9299”, “C1874”, “E1399”), or a 2-character modifier (e.g. “A1”). Digit-leading CPT codes are not in this dataset.
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string
“code” for the ~8,700 HCPCS Level II codes, “modifier” for the ~380 two-character HCPCS modifiers. Omit for both.Values: code, modifier.
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string
BM25 keyword match on the long and short descriptors (e.g. “wheelchair cushion”, “injection pembrolizumab”).
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string
Exact CMS coverage code, a single uppercase letter. These five are the complete set present in the current release: “C” (carrier judgement), “D” (special coverage instructions apply), “I” (not payable by Medicare), “M” (non-covered by Medicare), “S” (non-covered by Medicare statute).Values: C, D, I, M, S.
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string
Exact CMS pricing indicator code (e.g. “13”, “00”), which encodes how the item is priced for Medicare.
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string
Exact Berenson-Eggers Type of Service (BETOS) code (e.g. “D1E”), a clinical category grouping.
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boolean
True to keep only codes with no termination date (or a future one) as of the current quarterly release; False for retired codes only.
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integer
Exact year the code was added to HCPCS (e.g. 2024).
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integer
Inclusive lower bound on the year the code was added.
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integer
Inclusive upper bound on the year the code was added.

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Fields

Each result from this dataset has these in fields: action_code, action_effective_date, betos_code, code_added_date, coverage_code, cross_reference_code, entry_type, hcpcs_code, id, is_active, lab_certification_code, long_description, pricing_indicator_code, short_description, source_quarter, termination_date, url, year