Releases › HCPCS Level II July 2026

HCPCS Level II July 2026

Effective 2026-07-01 to 2026-09-30. 9,109 codes in the release.

41added
5revised
1removed

Codes added 41

CodeDescription
A9574 Injection, ferumoxytol, 1 mg
AC Initial onboarding support payment for access beneficiary enrollment, device/app setup, and care coordination activities; first month only; once per beneficiary per track
C1609 Vertebral device, motion-preserving, with screw fixation
C8014 Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, including use of a suction enabled ureteral access sheath, with irrigation (if performed)
C9310 Injection, leucovorin calcium (avyxa), 1 mg
G0574 Management of new patient with dementia residing in an eligible residential care community, for use only in a medicare-approved cmmi model (services must be furnished within a patient's eligible residential care community, including assisted living facilities, board and care homes, or other qualifying residential settings where dementia care services are provided)
G0575 Management of established patient with dementia residing in an eligible residential care community, for use only in a medicare-approved cmmi model (services must be furnished within a patient's eligible residential care community, including assisted living facilities, board and care homes, or other qualifying residential settings where dementia care services are provided)
G0577 Vascular embolization or occlusion procedure with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction performed in the non-facility setting
G0669 Outcome-aligned payment (oap) for technology-enabled chronic care management of early cardio-kidney-metabolic (eckm) conditions (hypertension, or two or more of: dyslipidemia, obesity/overweight with central obesity marker, prediabetes); initial 12-month period; per month
G0670 Outcome-aligned payment (oap) for technology-enabled chronic care management of early cardio-kidney-metabolic (eckm) conditions (hypertension, or two or more of: dyslipidemia, obesity/overweight with central obesity marker, prediabetes); follow-on 12-month period; per month
G0671 Outcome-aligned payment (oap) for technology-enabled chronic care management of cardio-kidney-metabolic (ckm) conditions (one or more of: diabetes mellitus, chronic kidney disease stage 3a or 3b, atherosclerotic cardiovascular disease); initial 12-month period; per month
G0672 Outcome-aligned payment (oap) for technology-enabled chronic care management of cardio-kidney-metabolic (ckm) conditions (one or more of: diabetes mellitus, chronic kidney disease stage 3a or 3b, atherosclerotic cardiovascular disease); follow-on 12-month period; per month
G0673 Outcome-aligned payment (oap) for technology-enabled chronic care management of musculoskeletal (msk) conditions (chronic musculoskeletal pain); initial 12-month treatment period; per month
G0674 Outcome-aligned payment (oap) for technology-enabled chronic care management of behavioral health (bh) conditions (one or more of: depression, anxiety); initial 12-month period; per month
G0675 Outcome-aligned payment (oap) for technology-enabled chronic care management of behavioral health (bh) conditions (one or more of: depression, anxiety); follow-on 12-month period; per month
G0676 Standard co-management service payment for documented review of clinical updates from access participant managing cardio-kidney-metabolic conditions (early cardio-kidney-metabolic [eckm] or cardio-kidney-metabolic [ckm] track); per review
G0677 Standard co-management service payment for documented review of clinical updates from access participant managing musculoskeletal (msk) conditions; per review
G0678 Standard co-management service payment for documented review of clinical updates from access participant managing behavioral health (bh) conditions (depression, anxiety); per review
J0528 Injection, fosfomycin disodium, 20 mg
J1289 Injection, narsoplimab-wuug, 1 mg
J1577 Injection, immune globulin (qivigy), 100 mg
J2361 Injection, depemokimab-ulaa, 1 mg
J2374 Apraclonidine hydrochloride ophthalmic, 1% solution, 0.1 ml
J2789 Riboflavin 5'-phosphate, ophthalmic solution (epioxahd/epioxa), up to 2 ml
J3386 Injection, etuvetidigene autotemcel, per treatment
J3405 Injection, onasemnogene abeparvovec-brve, per treatment
J7176 Injection, human fibrinogen - chmt (fesilty), 1 mg
J9053 Injection, belantamab mafodotin-blmf, 0.1 mg
J9062 Injection, amivantamab 5 mg and hyaluronidase-lpuj
J9232 Injection, docetaxel (hospira), not therapeutically equivalent to j9171, 1 mg
M0231 Intravenous infusion, tocilizumabbavi, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation only, includes infusion and post administration monitoring, first dose
M0232 Intravenous infusion, tocilizumabbavi, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation only, includes infusion and post administration monitoring, second dose
Q0234 Injection, tocilizumab-bavi, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation only, 1 mg
Q5164 Injection, ustekinumab-hmny (starjemza), biosimilar, 1 mg
Q5165 Injection, denosumab-mobz (oziltus), biosimilar, 1 mg
Q5166 Injection, denosumab-desu (osvyrti/jubereq), biosimilar, 1 mg
Q5167 Injection, denosumab-qbde (enoby/xtrenbo), biosimilar, 1 mg
Q5168 Injection, ranibizumab-leyk (nufymco), biosimilar, 0.1 mg
Q5169 Injection, pegfilgrastim-unne (armlupeg), biosimilar, 0.5 mg
Q5170 Injection, aflibercept-boav (eydenzelt), biosimilar, 1 mg
Q5171 Injection, denosumab-mobz (boncresa), biosimilar, 1 mg

Descriptions revised 5

CodeWas, and is now
C9761 Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, and ureteral catheterization for steerable vacuum aspiration of the kidney, collecting system, ureter, bladder, and urethra if applicable (must use a steerable ureteral catheter) Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, and ureteral catheterization for steerable vacuum aspiration of the kidney, collecting system, ureter, bladder, and urethra if necessary, with use of steerable ureteral catheter or suction-integrated ureteroscope
C9809 Cryoablation needle (e.g., iovera system), including needle/tip and all disposable system components, non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgical pain relief in accordance with section 4135 of the caa, 2023) Cryoneurolysis needle (e.g., iovera system), including needle/tip and all disposable system components, non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgical pain relief in accordance with section 4135 of the caa, 2023)
J1569 Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg Injection, immune globulin, (gammagard liquid/gammagard liquid erc), 500 mg
J2787 Riboflavin 5'-phosphate, ophthalmic solution, up to 3 ml Riboflavin 5'-phosphate, ophthalmic solution (photrexa viscous/photrexa), up to 3 ml
J3375 Injection, vancomycin hydrochloride (xellia), not therapeutically equivalent to j3373, 10 mg Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg

Terminated 1

CodeDescription
C9309 Injection, onasemnogene abeparvovec-brve, per treatment