hcpcs data

Carrier judgment

Every HCPCS Level II code whose Medicare coverage status is "Carrier judgment".

Medicare coverageCMS code C5,376 codes

What this status means

Medicare coverage is left to the judgment of the local Medicare Administrative Contractor (MAC), so check your MAC's local coverage determinations.

By series

These 5,376 codes span 13 series, split as below. Opening one shows that whole series, not just the codes listed here.

All codes 5,376

All code series

About this list

Coverage status comes from the Medicare coverage field in the CMS HCPCS release. It describes how Medicare treats the code, not whether a particular claim will be paid: that depends on the patient, the documentation and your payer's policy. The largest group here is the G series (Procedures / Professional Services (Temporary)).