September 25, 2025
October 2025 HCPCS Updates – New, Revised, and Discontinued HCPCS Codes and Modifiers
The following information is based on the October 2025 Healthcare Common Procedure Coding System (HCPCS) file. There are several updates that will be effective October 1, 2025. Please keep in mind that the appearance of a HCPCS code is not an indication of coverage by the DME MAC.
This following list contains added HCPCS codes that will be effective October 1, 2025.
| HCPCS | DESCRIPTION |
|---|---|
| A4288 | Valve for breast pump, replacement |
| E0150 | Combination wheeled walker with seat and transport chair, folding, adjustable or fixed height |
| E0658 | Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest |
| E0659 | Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest |
| E0765 | Fda approved nerve stimulator, for treatment of nausea and vomiting |
| J0163 | Injection, epinephrine in sodium chloride (endo), 0.1 mg |
| J0164 | Injection, epinephrine in sodium chloride (baxter), 0.1 mg |
| J0458 | Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg) |
| J0462 | Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg |
| J0525 | Injection, cefotetan disodium, 10 mg |
| J0582 | Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg |
| J0614 | Injection, treosulfan, 50 mg |
| J0668 | Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg |
| J0675 | Injection, carboprost tromethamine, 0.1 mg |
| J0681 | Injection, ceftobiprole medocaril sodium, 3 mg |
| J0738 | Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv) |
| J0752 | Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv) |
| J0759 | Injection, clevidipine butyrate, 1 mg |
| J1370 | Injection, esomeprazole sodium, 1 mg |
| J1612 | Injection, glucagon (gvoke), 0.01 mg |
| J1807 | Injection, ethacrynate sodium, 1 mg |
| J1809 | Injection, fosdenopterin, 0.1 mg |
| J1834 | Injection, isoniazid, 1 mg |
| J2151 | Injection, mannitol, 250 mg |
| J2291 | Injection, nafcillin sodium (baxter), 20 mg |
| J3290 | Injection, tranexamic acid, 5 mg |
| J3402 | Injection, remestemcel-l-rknd, per therapeutic dose |
| J9011 | Injection, datopotamab deruxtecan-dlnk, 1 mg |
| L1007 | Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla, to trochanter, includes all accessory pads, straps, and interface, custom fabricated |
| L5657 | Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials |
| L6034 | Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at transmetacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692 |
| L6035 | Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement |
| L6036 | Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement |
| L6038 | Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material |
| L6039 | Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb |
| Q5155 | Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg |
| Q5156 | Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg |
The following HCPCS codes have description/verbiage changes that will be effective October 1, 2025.
| HCPCS | DESCRIPTION |
|---|---|
| E0765 | Fda approved nerve stimulator, for treatment of nausea and vomiting |
| E0986 | Manual wheelchair accessory, power assist system |
| J1961 | Injection, lenacapavir (only for use as hiv treatment), 1 mg |
| J9072 | Injection, cyclophosphamide (frindovyx), 5 mg |
| L5673 | Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism |
| L5679 | Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism |
| L5783 | Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit) |
| L6028 | Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, including palm, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692 |
| L7406 | Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit) |
The following list contains discontinued HCPCS codes, along with the cross-walked HCPCS codes (if applicable). Please note, not all discontinued HCPCS codes will have a cross-walked HCPCS code.
| HCPCS | DISCONTINUE DATE | CROSSWALK HCPCS CODE |
|---|---|---|
| J2150 | 09/30/2025 | |
| J2503 | 09/30/2025 |
Updated: 09.25.2025

