Health Care Common Procedure Coding System (HCPCS) Level II Codes

AAC and Other Speech-Language Pathology Related Devices

While CPT codes identify procedures or services, HCPCS Level II codes identify supplies, equipment and devices, and procedures not found in the CPT system. The HCPCS codes (referred to as Hic-Picks) are administered by the Centers for Medicare and Medicaid Services (CMS) and begin with a single letter (A through V), followed by four numeric digits. They are grouped by the type of service or supply they represent and are updated annually by CMS with input from private insurance companies. HCPCS Level II codes are required for claims for supplies and devices covered by Medicare and Medicaid and by most private payers. Providers should always check with payers regarding coverage of HCPCS Level II codes.

HCPCS Level II includes codes for speech generating devices, voice prosthetics, voice amplifiers, and repair of AAC systems or devices. Please note that Medicare claims for E and L codes and V5336 fall under the jurisdiction of the Durable Medical Equipment Medicare Administrative Contractors (DME MACs). 

For further information, please contact reimbursement@asha.org.

Selected HCPCS Level II Modifiers

Modifiers are used when a HCPCS code needs to be supplemented to identify specific circumstances that may apply to an item or service. 

• NU - New DME purchase
• RA - Replacement of a DME, orthotic or prosthetic item
• RB - Replacement of a part of a DME, orthotic or prosthetic item furnished as part of a repair
• RR - Rental
• UE - Used DME purchase

[1] HCPCS Level II G codes are temporary codes developed and used by Medicare to identify professional health care procedures and services that would otherwise be reported using CPT codes, but for which there are no CPT codes. Medicare providers should check with their MACs regarding use of G codes for reporting procedures and services. Medicaid and other private payers may or may not adopt G codes.

[2] Because CMS will no longer cover CPT 96110 Developmental screen, this supplemental G code, which is valued on the previously-published values of CPT code 96110, was added as a temporary code. Medicaid and private payers may sometimes, but not always, follow suit. There is no guarantee of continued reimbursement, but G0451 may be an alternative to 96110. Because of the potential for confusion with these codes, documentation should be very clear.

[3] S codes are primarily used by private insurers to report drugs, services, and supplies for which there are no national codes but for which codes are needed by the private sector to implement policies, programs, or claims processing. These codes may also used by Medicaid programs, but they are not payable by Medicare. Providers should always check with payers regarding use of S codes.

[4] Speech-language pathology services are typically reported using Current Procedural Terminology (CPT) codes, regardless of the treatment technique used, such as hippotherapy. Additional information on hippotherapy is available from the American Hippotherapy Association, Inc. Speech-language pathologists should should contact payers directly regarding use of S8940. 

[5] T codes are for use primarily by Medicaid State agencies to identify items for which there are no permanent national codes and for which codes are necessary to meet a national Medicaid program operating need. T codes may be also used by private insurance programs, but they are not payable by Medicare. Providers should always check with payers regarding use of T codes.