HCPCS has two levels. Level I is CPT, maintained by the American Medical Association, for procedures and services. Level II is maintained by CMS and covers products, supplies and services that CPT does not, including drugs in the J range.
Two levels, two maintainers
HCPCS Level I is CPT. The AMA maintains it and updates it annually. HCPCS Level II is maintained by CMS, updated quarterly, and uses a letter followed by four digits (J9271, Q5115, A4253).
Which one describes the drug and which the service
For a drug given in a clinic, the drug is usually a HCPCS Level II line (often a J-code) with its units and NDC, and the administration is a separate CPT line. For example, an intravenous infusion of an immunotherapy drug would typically be reported as the drug's J-code with units based on the dose, plus a CPT code from the chemotherapy and complex drug administration family for the infusion time.
The vaccine exception
Vaccines are reported with a CPT vaccine product code for the vaccine and a CPT immunization administration code for giving it. Some payers and programs use HCPCS Level II G-codes for administration of specific vaccines; check the payer's rules.
Questions
Are HCPCS Level II codes free to use?
Yes. CMS publishes HCPCS Level II codes and descriptors publicly. CPT descriptors are licensed by the AMA.