Medicare Fee For Service HIPPS Codes
Guidance for the use and maintenance of the Health Insurance Prospective Payment System (HIPPS) coreset.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: August 05, 2020
This web page contains information related to the use and maintenance of the Health Insurance Prospective Payment System (HIPPS) codeset. The Centers for Medicare and Medicaid Services (CMS) are named in the ASC X12 837 Institutional Claim Implementation Guide as the code source for HIPPS codes.
- Definition and Uses of HIPPS Codes (PDF) (Updated 04/01/2022)
- HIPPS Code Master List (ZIP) (Updated 11/19/2020) - an Excel spreadsheet that provides a complete list of all valid HIPPS codes, with their effective dates, payment settings and code definitions.
- Change Request Process (PDF) - describes the steps necessary to request a modification in the HIPPS codeset and the CMS code approval process.
- Change Request History (ZIP) (Updated 08/21/2019) - an Excel spreadsheet that documents the disposition of all change requests received as of the most recent HIPPS code update.
Contact HIPPS: If you have questions regarding the HIPPS codeset that are not answered in the information below, write to HIPPS@cms.hhs.gov.
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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.