Important Update: New HCPCS Codes for Hydrophilic Catheters

WOCN wants to ensure our members are fully informed about an important change affecting hydrophilic intermittent catheter billing codes.

 

Beginning January 1, 2026, CMS will introduce new HCPCS billing codes that differentiate hydrophilic catheters from non-hydrophilic catheters. This is a coding update, not a coverage change — but it requires action to ensure catheter users continue receiving the hydrophilic catheter their clinician prescribed.

 

What to do when writing prescriptions:

  • New prescriptions:
    • Exclude HCPCS codes. Write “hydrophilic” or list the brand name/item number
  • Renewal prescriptions:
    • Expect updated forms from suppliers
    • Review carefully to ensure they say “hydrophilic” or brand/item number, and remove old codes
  • Timing matters:
    • Prescriptions updated this way are valid in 2025 and will continue to work when the new codes take effect January 1, 2026

 

Why it matters:

  • Protects your clinical decision and ensures patients remain on the catheter you prescribed.
  • Prevents delays or substitutions caused by prescriptions with outdated codes.
  • Helps catheter users stay consistent with their catheterization routines, supporting better outcomes.
  • Allows the medical supplier to submit insurance claims utilizing the appropriate codes.

 

We encourage all members to begin updating prescriptions now, educate your teams and case managers, and be proactive with suppliers. Early action helps safeguard continuity of care.

 

WOCN is committed to keeping our community informed. Please reach out to us with any questions info@wocn.org.