Reimbursement intelligence
The HCPCS Quarterly Update explained
How HCPCS Level II codes change four times a year, what each quarterly update touches — new drug J-codes, supplies, and G/Q codes — and how to keep your charge master current with the January, April, July, and October cycles.
Last reviewed June 19, 2026
Unlike CPT and ICD-10, which update once a year, HCPCS Level II changes four times a year — on January 1, April 1, July 1, and October 1. The quarterly cadence exists because HCPCS Level II carries the codes for drugs, biologicals, supplies, and devices that come to market on their own schedule, and their pricing moves quarterly too. This guide explains the cycle, what each update touches, and how to keep your charge master and edits current.
What HCPCS Level II is
HCPCS Level II is the alphanumeric code set CMS maintains for products and services not covered by CPT (HCPCS Level I) — drugs and biologicals (J-codes), durable medical equipment and supplies (A/E codes), temporary and procedural codes (G-codes), and other temporary codes (Q and others). It's how a Part B drug, a wheelchair, or a screening service gets identified on a claim.
Because these products reach the market continuously, CMS updates HCPCS Level II quarterly rather than annually — so a new drug can get a permanent J-code, or a temporary code can be replaced, without waiting for a January cycle.
The quarterly cycle
HCPCS Level II updates land on a fixed quarterly schedule, with CMS posting the update files ahead of each effective date:
- January 1: The largest update — aligns with the annual cycle and carries the most new, revised, and deleted codes.
- April 1: A quarterly update, often new drug and biological codes and temporary-code changes.
- July 1: A quarterly update; new codes and replacements that couldn't wait for January.
- October 1: A quarterly update that aligns with the start of the federal fiscal year and the ICD-10 cycle.
What each update touches
The quarterly changes that most affect getting paid:
- New drug & biological J-codes: Newly approved drugs receive permanent J-codes, often replacing a temporary or not-otherwise-classified code that was used in the interim.
- Drug pricing (ASP): Average Sales Price payment limits for Part B drugs are updated quarterly — the same cadence as the code changes.
- G and Q codes: Temporary procedural and supply codes are added, revised, or replaced as policy and products change.
- Deletions and crosswalks: Retired codes and their replacements — billing a deleted HCPCS code after its effective date rejects the claim.
How to keep current each quarter
A short recurring routine keeps the quarterly cadence from becoming a surprise:
- Calendar the four dates: Treat January, April, July, and October 1 as standing charge-master review points.
- Reconcile your drug codes: Map interim/not-otherwise-classified drug codes to the new permanent J-codes as they're assigned.
- Update ASP pricing: Load the quarterly ASP file so Part B drug payment limits stay current.
- Test deletions before go-live: Confirm replaced codes are mapped so claims don't reject on the effective date.
How CLV Intelligence tracks HCPCS updates
CLV Intelligence monitors the quarterly HCPCS Level II updates and the CMS and MAC policy that governs the codes — surfacing new, revised, and deleted codes and the coverage changes attached to them, linked to the source. See the HCPCS update tracker for how the product works, or look up any code in the directory for its coverage and active alerts.
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Frequently asked questions
How often is HCPCS Level II updated?
Four times a year — on January 1, April 1, July 1, and October 1. This quarterly cadence is different from CPT and ICD-10, which update annually, and exists because HCPCS Level II carries drug, biological, and supply codes that come to market and reprice on a rolling basis.
Why does HCPCS update quarterly when CPT and ICD-10 are annual?
Because HCPCS Level II identifies products — drugs, biologicals, devices, and supplies — that reach the market continuously, and Part B drug pricing (ASP) is itself updated quarterly. A quarterly cycle lets CMS assign permanent codes and update payment limits without waiting for an annual update.
What happens if I bill a deleted HCPCS code after its effective date?
The claim is rejected. When a HCPCS code is deleted or replaced in a quarterly update, it is no longer valid for dates of service on or after the effective date — which is why mapping deletions to their replacement codes before each quarter matters.
Is this guide billing, coding, or legal advice?
No. CLV Intelligence is a monitoring and reference tool, not a billing, coding, legal, or reimbursement-advisory service. This guide explains the HCPCS update cycle so your team knows where to look — always confirm against the official CMS HCPCS files and your Medicare Administrative Contractor's guidance.
Keep monitoring
HCPCS Update Tracker
How CLV tracks HCPCS additions, revisions, and deletions.
ICD-10 Change Center
The annual ICD-10-CM update cycle and FY2027 changes.
2027 Fee Schedule Guide
How the CY2027 Medicare Physician Fee Schedule works.
Code lookup
Look up any HCPCS code for coverage and active alerts.
Reimbursement alert feed
The live feed of CMS, MAC, and Federal Register changes.
Track the CY2027 rule before it hits a claim.
See the live feed of CMS and MAC policy changes, or talk to us about coverage for your team.