HMSA defines Cost-Based Items as “Tangible goods that are placed in possession of the patient such as a drug, infused product, supply or implant”.
Below are the code ranges for Cost-Based Items:
| Code Category | Code Category Information | Code RANGE* |
|---|---|---|
| HCPCS A Codes | Medical and Surgical Supplies | A2014-A2021, A4101-A4590, A4595-A4932, A5001-A5514, A6000-a6459, A6462-A6599, A6600-A6611, A7000-A7046, A7048-A7527, A8000-A8006, A9156, A9294, A9500-A9506, A9612, A9616, A9573, A9602-A9800 |
| HCPCS B Codes | Enteral and Parenteral Supplies/Products | B4034-B4104, B4106-B4224, B5000-B5200, B9002-B9999 |
| HCPCS C Codes | Outpatient PPS – Supplies/Products | C1607, C1608, C1713-C1714, C1721-C1722, C1724-C1733, C1737, C1739, C1740-C1742, C1749-C1760, C1762-C1773, C1776-C1789, C1813-C1822, C1830, C1881-C1888, C1891-C1900, C2613-C2614, C2617-C2631, C9352-C9353, C9355, C9359, C9361-C9362 |
| HCPCS E Codes | Durable Medical Equipment (DME) | E0100-E0149, E0153-E0199, E0200, E0202-E0230, E0233-E0297, E0300-E0373, E0424-E0445, E0468, E0500-E0585, E0600-E0669, E0671-E0675, E0677-E0694, E0700-E0791, E0830-E0890, E0900-E0995, E1002-E1799, E1803-E1804, E1807-E1809, E1813-E1814, E1817, E1819, E1822-E1824, E1826-E1829, E1833-E1839, E1842-E1905, E2000-E2298, E2301-E2357, E2359, E2361, E2363, E2365-E2371, E2373-E2633, E8000-E8002 |
| HCPCS J Codes | Drugs | J0013, J0120-J0190, J0200-J0295, J0300-J0395, J0400-J0491, J0500-J0590, J0592-J0599, J0600-J0690, J0692-J0699, J0701-J0799, J0800-J0899, J0911, J0945, J1000-J1071, J1073-J1990, J2001-J2998, J3000-J3303, J3305-J3465, J7030-J7070, J7100-J7199, J7200-J7298, J7300-J7355, J7402, J7500-J7520, J7522-J7599, J7601-J7699, J7799, J7999, J7328, J8501-J8999, J9000-J9098, J9100-J9198, J9200-J9299, J9301-J9395, J9400, J9600, J9601, J9999 |
| HCPCS K Codes | Temporary Codes – DME | K0001-K0098, K0105-K0195, K0455-K0462, K0552-K0554, K0601-K0672, K0730-K0746, K0800-K0899, K0900, K1001, K1003, K1006-K1022, K1024-K1025, K1027, K1031-K1035 |
| HCPCS L Codes | Orthotics | L0112-L0190, L0200-L0220, L0450-L0492, L0621-L0651, L0700-L0710, L0810-L0861, L0970, L0999, L1007, L1320, L1681, L1933, L1952, L5657, L5783, L5827, L5841, L5926, L5991, L5992, L6028-L6039, L6037. L7406 |
| HCPCS Q Codes | Temporary Codes – Drugs, Biologicals, and Medical Equipment | Q0138-Q0181, Q0220-Q0249, Q0477-Q0499, Q0500-Q0515, Q2004-Q2057, Q3001-Q3028, Q4001-Q4082, Q4100-Q4102, Q4105-Q4107, Q4109, Q4114, Q4116, Q4119-Q4120, Q4122, Q4124, Q4129-Q4133, Q4144-Q4145, Q4151, Q4154, Q4168, Q4172, Q4176-Q4182, Q4186, Q4207, Q4223, Q4227-Q4233, Q4243, Q4250, Q4254-Q4255, Q4261, Q4265-Q4271, Q4431-Q4433, Q5098, Q5099, Q5100-Q5146, Q5147-Q5151, Q5153- Q5159, Q5160-Q5162, Q9950-Q9981, Q9984-Q9998 |
| HCPCS P Codes | Pathology and Laboratory Supplies/Products | P9010-P9099 |
| HCPCS S Codes | Temporary National Codes (Non-Medicare) – Supplies/Products | S0012-S0093, S0104-S0199, S0500-S0596, S1002-S1090, S4989-S4995, S5000-S5014, S8096-S8999, S9007-S9024, S9026-S9431, S9433-S9435 |
| HCPCS V Codes | Vision, Hearing Supplies/Products | V2630-V2632, V5030-V5095, V5100-V5190, V5211-V5274, V5281-V5336 |
| CPT 9xxxx series | Vaccination Products | 90476, 90477, 90581-90589, 90611-90698, 90700-90759, 91300-91317 |
| CPT 9XXXX SERIES | IMMUNE GLOBULIN, SERUM, AND RECOMBINANT PRODUCTS | 90281-90288, 90291, 90296, 90371-90378, 90384-90689, 90393-90399 |
*Important Note: The above list of codes is not all inclusive and are subject to change. Please be sure to use the most up-to-date industry-standard procedure codes from the current CPT® and HCPCS Level II as recommended by the American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS).
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform.
|