October 2026 HCPCS file adds G0685 for algorithm-based ASD assessment
CMS posted the October 2026 Alpha-Numeric HCPCS file on August 18, 2026. It adds G0685 for an algorithm-based ASD assessment. Coverage is C and PRICE1 is 13, so the code is not nationally priced. Load the ZIP before October 1.
By the HCC Buddy Coding Team
Published August 25, 2026
Key Takeaways
- →CMS posted the October 2026 Alpha-Numeric HCPCS File (ZIP) on the HCPCS Quarterly Update page, marked Updated 08/18/2026. The page last-modified time is 08/18/2026 12:16 PM.
- →The file adds G0685, ACTION A (ADD), with ADD DT and ACT EFF DT 20261001. The long descriptor is Algorithm-based assessment of likelihood of autism spectrum disorder (asd), derived from validated analysis of eye-gaze data or other technology. The short descriptor is Algorithm assessment for asd.
- →G0685 has coverage indicator C (carrier judgment) and PRICE1 13 (price established by carriers). It is not nationally priced.
- →The October 2026 transaction report in the ZIP shows 44 ADD and 14 Discontinued. Load the official file. Do not recode from a 44-code list.
- →G0685 is a HCPCS Level II service code. It is not an ICD-10-CM diagnosis, not a V28 map, not the FY 2027 MS-DRG V44 errata, and not CPT Appendix S.
CMS posted the October 2026 Alpha-Numeric HCPCS File (ZIP) on the HCPCS Quarterly Update page, marked Updated 08/18/2026. The page last-modified time is 08/18/2026 12:16 PM. That ZIP is the chargemaster and encoder load for October 1, 2026.
This is not the FY 2027 MS-DRG V44 errata. That errata added two ICD-10-PCS codes. This file adds a HCPCS Level II code.
The new code
The October 2026 alpha-numeric file adds G0685. ACTION is A (ADD). ADD DT and ACT EFF DT are both 20261001.
| Field in the October 2026 file | Value |
|---|---|
| HCPC | G0685 |
| ACTION | A (ADD) |
| ADD DT / ACT EFF DT | 20261001 |
| SHORT DESCRIPTION | Algorithm assessment for asd |
| LONG DESCRIPTION | Algorithm-based assessment of likelihood of autism spectrum disorder (asd), derived from validated analysis of eye-gaze data or other technology |
| COV | C |
| PRICE1 | 13 |
Do not treat G0685 as a diagnosis. It is a HCPCS Level II service code.
Coverage C and PRICE1 13
The record layout in the same ZIP defines those two fields. Coverage code C is carrier judgment. Pricing indicator 13 is price established by carriers (not otherwise classified, individual determination, carrier discretion).
That means G0685 is not nationally priced. Coverage and payment sit with the MAC. Load the code, then ask the MAC. Do not invent a fee or a national coverage rule.
What this is not
It is not an ICD-10-CM diagnosis and it does not get a V28 map. If the question is risk adjustment, use the model year you are actually coding in ICD-10 to HCC.
It is not the FY 2027 MS-DRG V44 errata and it is not a grouper change.
It is not CPT 2027 Appendix S. Appendix S is an AMA CPT taxonomy. G0685 is a CMS HCPCS Level II add.
It is not the G2025 telehealth billing change. That is a different October 1, 2026 HCPCS instruction.
The October file, not a 44-code list
The transaction report inside the ZIP shows 44 ADD and 14 Discontinued. Those are file counts. Do not turn the 44 into a recode list. Load the official ZIP.
What to do before October 1
1. Download the October 2026 Alpha-Numeric HCPCS File (ZIP) from the CMS quarterly-update page.
2. Add G0685 to the chargemaster and encoder. Use the long and short descriptors from the file.
3. Ask the MAC how G0685 is covered and priced in your jurisdiction. COV C and PRICE1 13 do not give a national rate.
4. Do not map G0685 to a CMS-HCC or treat it as a diagnosis.
5. Look up the descriptor in the encoder when you need the wording next to a record, not a list of 44 codes.
Frequently Asked Questions
What is HCPCS G0685?
G0685 is a HCPCS Level II code added in the October 2026 Alpha-Numeric HCPCS file. The long descriptor is Algorithm-based assessment of likelihood of autism spectrum disorder (asd), derived from validated analysis of eye-gaze data or other technology. The short descriptor is Algorithm assessment for asd. ACTION is A (ADD). ADD DT and ACT EFF DT are 20261001.
When is G0685 effective?
The October 2026 file lists ADD DT and ACT EFF DT as 20261001, so October 1, 2026. CMS posted the ZIP on the HCPCS Quarterly Update page as Updated 08/18/2026.
Is G0685 nationally priced?
No. The October 2026 file sets COV to C (carrier judgment) and PRICE1 to 13 (price established by carriers). Ask the MAC for coverage and price. The file does not publish a national rate.
Does G0685 map to a V28 HCC?
No. G0685 is a HCPCS Level II service code, not an ICD-10-CM diagnosis. It does not get a CMS-HCC or V28 map.
Sources
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HCC Buddy Coding Team
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Every HCC Buddy news article is checked against the current CMS-HCC model and the active FY ICD-10-CM tabular release before it publishes.
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