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What are CPT Codes?

CPT stands for “current procedural terminology.”  CPT codes are a set of codes developed several medical organizations in the United states for the purpose of helping the U.S. federal government to administer the health insurance program Medicare.

CPT codes are numeric, and code for medical, surgical, and diagnostic services.  The codes and descriptions are copyright 2007 by the American Medical Association. 

Who developed the CPT Codes? 

The CPT codes were first developed by the American Medical Association (AMA), and published in 1966.  The Centers for Medicare and Medicaid Services (CMS) eventually adopted CPT as part of their coding system. 

Are CPT codes the only codes used in Medicare?

The set of CPT codes is only a subset of a larger group of codes.  The coding system actually includes two levels of codes:

1. Level I Codes – CPT codes
2. Level II Codes – HCPCS or national codes

Why was the coding system created?

The coding system provides a common billing language for health care providers and payers.  The Health Insurance Portability and Accountability Act (HIPAA) of 1996 standardized all health care claim formats by naming the CPT and HCPCS codes as the procedure code set for physician services, PT and OT services, clinical lab tests and other medical services.  This occurred on August 17, 2000.

What is the HCPCS? 

HCPCS stands for Healthcare Common Procedure Coding System.  HCPCS is commonly pronounced as “hick-picks.”  These codes supplement the CPT coding system, and describes some supplies, orthotics and prosthetics, and durable medical equipment.  These codes are used primarily for Medicare and Medicaid billing.  The code consist of one alphabetical character (A through V), followed by four numbers.

Examples of common HCPCS codes used in physical therapy include: