How to cite: Powley, Gina. “CMS HCPCS Code Changes for Intermittent Catheters.” September 15, 2025. Accessed Oct 2025. https://grandroundsinurology.com/cms-hcpcs-code-changes-for-intermittent-catheters/
CMS HCPCS Code Changes for Intermittent Catheters – Summary
Diane K. Newman, DNP, ANP-BC, FAAN, FAUNA, BCB-PMD, Urology and Pelvic Floor Nurse Specialist, University of Pennsylvania, Philadelphia, Pennsylvania, Adjunct Professor of Surgery Division of Urology, Perelman School of Medicine Emerita, introduces Gina Powley, MSN, ANP-BC, CUNP, FAUNA, Clinical Resource Manager, Hollister Inc., who reviews the upcoming Centers for Medicare & Medicaid Services (CMS) Healthcare Common Procedure Coding System (HCPCS) code changes for intermittent catheters, marking the first major update in decades.
Over 1,300 intermittent catheterization (IC) products were constrained under just three HCPCS codes, limiting the ability to track product use, ensure patient continuity, and distinguish innovations such as hydrophilic technology. Clinicians often faced difficulty ensuring patients received the prescribed product. After years of advocacy, including a multi-stakeholder coalition of manufacturers, clinicians, and associations, CMS agreed to expand the IC codes. Effective January 1, 2026, three new codes will be added for hydrophilic-coated products, bringing the total to six.
Clinicians prescribing hydrophilic catheters must ensure orders specify the new codes; otherwise, new prescriptions will be required. Documentation should clearly state hydrophilic use, brand/model, or “hydrophilic catheter.” Significantly, CMS has not added new qualifiers, documentation burdens, or reimbursement differences.
Nurse Practitioner Powley emphasizes that hydrophilic catheters may reduce trauma and infection, and the new codes better reflect real-world practice. For clinicians, the key is to educate patients, prescribe specifically, and update charting practices by 2026.
