X-code

An X-Code refers to a temporary HCPCS Level II “C-code” or “X-code” assigned by CMS (Centers for Medicare & Medicaid Services) to facilitate reimbursement of new medical technologies, often in the outpatient hospital or ambulatory surgical center (ASC) setting.

X-Codes are typically used when a permanent CPT® code does not yet exist for a new procedure, product, or device. They provide a billing pathway for hospitals to report and receive transitional pass-through payments (TPT) or device-specific reimbursement while the manufacturer pursues a permanent coding solution.

At Lonsberry Consulting™, we help MedTech companies strategically obtain and leverage X-Codes as part of an integrated PRECODE™ commercialization strategy—ensuring your product doesn’t just launch, but gets reimbursed and adopted.

✅ Provides a temporary reimbursement path while CPT or APC updates are pending
✅ Enables hospital billing under CMS Outpatient Prospective Payment System (OPPS)
✅ Supports Transitional Pass-Through (TPT) Payments for certain drug, device, and diagnostic innovations
✅ Signals payer recognition of innovation in the absence of formal codes
✅ Builds utilization data for permanent code applications

Lonsberry Consulting™ guides you through the end-to-end process of identifying, requesting, and deploying X-Codes or temporary HCPCS codes, including:

• Assessing the need for an X-Code vs. alternative coding strategies
• Coordinating with CMS and MACs (Medicare Administrative Contractors)
• Submitting a formal X-Code request, including clinical and economic justification
• Designing claims and coding education for hospital billing teams
• Developing utilization and outcomes data to support permanent CPT® or HCPCS code applications

In the PRECODE™ framework, coding is not an afterthought—it’s a strategic building block. We help you integrate X-Code requests into your pre-market planning, aligning product use, billing pathways, and payer engagement before you launch.

• Innovative outpatient technologies without an existing CPT® or HCPCS code
• Diagnostic devices, implants, or procedures needing temporary billing identifiers
• Companies pursuing Transitional Pass-Through (TPT) or New Technology APC assignment
• Startups preparing for early adoption in hospital or ASC environments

In today’s value-driven healthcare system, no code means no payment. X-Codes offer a way to bridge that gap—but only if you understand how to use them strategically.

We help you make X-Codes part of a long-term reimbursement roadmap, not a short-term fix.