U5 HCPCS Level II modifier: Medicaid level of care 5, as defined by each state
U5 is a HCPCS Level II modifier: “Medicaid level of care 5, as defined by each state.” It adds this detail to the code it is reported with.
Official description
U5Medicaid level of care 5, as defined by each state
Short description: M/caid care lev 5 state def
HCPCS · United States
Medicare details
The indicators CMS publishes with U5 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Not payable by Medicare
- Added
- Jul 1, 2002
Where U5 sits
- 1GroupHCPCS modifiers
- 2Modifier U5Medicaid level of care 5, as defined by each state
Source and release
- Data release
- HCPCS Level II · October 2026
- Effective date
- Oct 1, 2026
- Publisher
- CMS
This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.
Frequently asked questions
What does HCPCS code U5 mean?
U5 is the HCPCS code for “Medicaid level of care 5, as defined by each state” in CMS’s HCPCS Level II October 2026 release.
Where is U5 in the HCPCS Level II list?
U5 is listed under Modifiers.
Does Medicare cover U5?
CMS lists U5’s Medicare coverage as “Not payable by Medicare”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.
Which HCPCS Level II release does this page use?
It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.
Codes beside U5
All modifiersTVSpecial payment rates, holidays/weekendsTWBack-up equipmentU1Medicaid level of care 1, as defined by each stateU2Medicaid level of care 2, as defined by each stateU3Medicaid level of care 3, as defined by each stateU4Medicaid level of care 4, as defined by each stateU6Medicaid level of care 6, as defined by each stateU7Medicaid level of care 7, as defined by each stateU8Medicaid level of care 8, as defined by each stateU9Medicaid level of care 9, as defined by each stateUAMedicaid level of care 10, as defined by each stateUBMedicaid level of care 11, as defined by each state