We explain that what is the difference between HCPCS and CPT with table (HCPCS vs CPT). HCPCS and CPT work hand in hand. HCPCS is short for Healthcare Common Procedure Coding System. Medical workers use it to claim their health insurance from insurance companies. Current Procedural Terminology (CPT) is the set of codes used to direct the use of medical procedures to authorities. HCPCS vs CPT
HCPCS codes consist of three levels, Level 1, Level 2, and Level 3. CPT codes are required to claim physician and surgeon services from payers for these services. This practice is done in Level 1 coding. Level 2 coding is intended for healthcare workers to apply for medical insurance for medical instruments. This level consists of nationalized codes. HCPCS vs CPT
CPT codes are those used in HCPCS Level 1 coding. They contain the procedures to be followed by different medical departments during an operation. The American Medical Association has assigned three categories in CPT coding. They are Category 1, Category 2 and Category 3. HCPCS vs CPT
The difference between HCPCS and CPT is that HCPCS is used to provide a standardized system for coding health services using CPT codes. While the CPT codes are those that contain a detailed description of the codes that users of medical instruments must follow when using surgical, medical and diagnostic instruments.
Comparison table between HCPCS and CPT (in tabular form)
HCPCS CPT comparison parameters
| Value | HCPCS codes are used to provide a standardized description of the provision of healthcare services. | CPT codes are used to describe the services that medical workers must recognize. |
| Protection | The Health Insurance Portability and Accountability Act states that everyone should have the freedom to access HCPCS procedures. | CPT codes have been owned by the American Medical Association and outsiders have to pay to access them. |
| Divisions | HCPCS operates on three levels. Namely, level 1, level 2 and level 3. | CPT has three categories. They are Category 1, Category 2 and Category 3. |
| Creators | HCPCS was created by the Centers for Medicare and Medicaid (CMS). | CPT was developed by the American Medical Association (AMA). |
| The affected | HCPCS has codes for direct and non-direct healthcare workers. | CPT codes are only for procedures to be operated on a patient. |
What is HCPCS?
The HCPCS codes have been developed by the Centers for Medicare and Medicaid organization. It was developed to identify the insurance policies for which one is eligible. Now anyone can easily access it, as HIPAA has made it free. It has three levels. Each of these levels describes the procedures that different healthcare workers need. HCPCS vs CPT
Level 1 contains the codes that have been addressed by the American Medical Association. These are the CPT codes. These codes are being used by direct healthcare workers. They consist of the procedures that must be known while operating on a patient. These medical services must be known to the medical, surgical and diagnostic departments.
HCPCS Level 2 consists of codes related to non-physical service providers. Ambulance services are primarily listed here. Level 2 subdivisions are in the format of a capital letter followed by a four-digit number. For example, code A0021 denotes procedures indicated for transportation, medical and surgical supplies, and miscellaneous and experimental activities.
Level 3 codes are called local codes. These codes are not currently in use but have a history as of December 31, 2003. This is because CPT developed a more reliable set of codes to describe health insurance in a specific program. HCPCS vs CPT
What is CPT? HCPCS vs CPT
The American Medical Association has produced CPTs to address procedures that medical professionals must follow while caring for patients. This is published by the CPT editorial panel at the AMA. In October of each year, the updated version of CPT is released. There are three categories in CPT.
Category 1 contains six main sections. They are Codes for evaluation and management, codes for anesthesia, codes for surgery, codes for radiology, codes for pathology and laboratory, and codes for medicine. When deeply reviewed, all of these divisions primarily influence the level of the head, the medical workers. HCPCS vs CPT
The second category in CPT defines the codes that clinics must follow when evaluating and administering them. The advisory board of CPT – Performance Measures Advisory Group edits and reviews this category. The codes are named in a pattern that begins with four digits followed by a capital letter.
The third category of CPT is driven by emerging technology in the medical field. Starts from 0016T – 0207T. Since WADA has the CPT rights, any organization that needs to access these codes has to pay them to do so. The latest version of CPT is CPT2020.
Main differences between HCPCS and CPT
- HCPCS is a standardized description of the procedures that a medical professional must follow while caring for a patient. CPT consists of the codes that describe this set of procedures.
- HIPAA has made it mandatory for anyone to access HCPCS. The CPT is copyrighted by AMA and is therefore a paid service.
- HCPCS is divided into three levels, mainly Level 1, Level 2 and Level 3. The CPT is divided into three categories, namely Category 1, Category and Category 3.
- The Centers for Medicare and Medicaid developed HCPCS. The American Medical Association is the creator of CPT.
- The codes in HCPCS are applicable to both direct and indirect medical professionals. The CPT is part of HCPCS and contains the rules to follow when treating a patient.
Final Thought
Both HCPCS codes and CPT codes are used to direct the services offered by physicians. HCPCS consists of three levels. Each of these levels consists of the codes to be followed by the different people related to the medical field in the performance of their functions. When claiming your health insurance, these should not be presented.
CPT codes are part of the HCPCS codes. They contain the codes that physicians must follow when diagnosing and treating a patient. There are three categories through which these procedures are explained. WADA has the rights to publish and renew these procedures.
