If you’ve ever felt lost in the sea of medical codes while managing billing for your therapy practice, you’re not alone. HCPCS codes (pronounced “hick-picks”) can feel overwhelming, especially when you’re juggling clinical care, scheduling, and compliance. But getting them right is critical.
These codes are used for everything from speech therapy evaluations to wheelchair rentals—and mastering them means cleaner claims, fewer denials, and faster reimbursements. Whether you’re running a small ABA clinic or a growing multidisciplinary practice, knowing the basics of HCPCS can make your admin life a whole lot easier.
HCPCS stands for Healthcare Common Procedure Coding System. It’s a standardized set of codes used across the U.S. to identify medical services, supplies, and equipment when billing Medicare and other health insurers.
There are two levels:
Together, these codes ensure that everyone—from your billing team to Medicare—understands exactly what was provided to a patient.
Therapy practices rely on HCPCS codes to:
Using the wrong code can delay reimbursement or lead to audits. For clinics offering speech, occupational, or ABA therapy, this can quickly become a serious financial bottleneck.
HCPCS Level II codes often apply even if you’re not billing Medicare. Many commercial payers also reference them.
Level II HCPCS codes follow this format:
G0151)Categories include:
Some codes require modifiers—two-letter or number additions that give context.
Example: G0151 = “Services of a physical therapist in a home health or hospice setting”.
HCPCS CodeDescriptionG0153Services by a speech-language pathologist (SLP)G0151Physical therapy servicesH2019Therapeutic behavioral services (ABA)T1013Sign language or oral interpretive servicesE1399Miscellaneous DME not otherwise classified
Ensure documentation and time-based reporting are accurate. Use billing software that supports modifiers.
1. What’s the difference between CPT and HCPCS codes?CPT codes are part of HCPCS Level I, for general medical services. HCPCS Level II covers supplies and non-physician services.
2. Are HCPCS codes only for Medicare?No. Many private insurers and Medicaid plans also use them.
3. Do ABA therapy services use HCPCS codes?Yes. Many ABA services are billed under H-codes like H2019.
4. What happens if I use the wrong HCPCS code?It can lead to claim denials or compliance issues. Always double-check with your billing team or software.
Understanding HCPCS codes is a key part of running an efficient and compliant therapy practice. From reimbursement to documentation, these codes matter.
Take time to audit your most-used codes or chat with your billing team. A little clarity goes a long way.
For a deeper dive, check out CPT resources from the AMA.