HCPCS Level III

E941363

HCPCS Level III was a category of locally developed medical billing codes, often created by state Medicaid agencies or private insurers, used to report services and supplies not covered by national HCPCS Level I and II codes.

All labels observed (2)

Label Occurrences
HCPCS Level III canonical 1
HCPCS local codes 1

How this entity was disambiguated

Statements (40)

Predicate Object
instanceOf healthcare reimbursement classification
medical billing code set
alsoKnownAs HCPCS local codes
linked to: HCPCS Level III

local codes
appliesTo items not described by national HCPCS codes
procedures
services
supplies
associatedWith Medicaid programs
linked to: Medicaid

Medicare administrative contractors
commercial health plans
classificationSystem procedure and supply coding
complements HCPCS Level I
HCPCS Level II
dataType alphanumeric codes
developedBy Medicare contractors
private insurers
state Medicaid agencies
domain health insurance claims
medical services coding
governedBy local payer policies
granularity payer-specific detail beyond national codes
maintenance maintained by individual payers rather than a single national body
notCoveredBy national HCPCS Level I codes
national HCPCS Level II codes
partOf Healthcare Common Procedure Coding System
purpose to allow payers to define additional billable services
to capture utilization of services unique to a region or payer
regulates reimbursement for locally defined services
relatedTo CPT
HCPCS Level II
replacedBy expanded use of national HCPCS Level I and II codes
scope local or regional use
payer-specific use
standardizationLevel less standardized than national HCPCS codes
status discontinued as a formal HCPCS level
usedFor healthcare claims processing
medical billing
reporting services and supplies not covered by national HCPCS codes
usedIn United States healthcare system

How these facts were elicited

Referenced by (2)

Full triples — surface form annotated when it differs from this entity's canonical label.

HCPCS Level III alsoKnownAs HCPCS local codes
linked to: HCPCS Level III