Introducing the CPT/HCPCS to Service Type Code lookup tool

You can now look up common Service Type Code (STC) mappings for a CPT or HCPCS procedure code using Stedi's free lookup tool.

You can use the STCs returned by the tool to test payer STC support and find the right STC to use in eligibility checks.

What is a Service Type Code?

A Service Type Code (STC) is a two-character code that groups related healthcare services into broad categories. Examples include 30 (Health Benefit Plan Coverage), MH (Mental Health), and UC (Urgent Care).

You include an STC in eligibility check requests to tell the payer what type of coverage and benefits you’re asking about.

Why don't procedure codes work for eligibility checks?

When you submit a claim, you use procedure codes, like CPT and HCPCS codes, to describe exactly what service was provided.

Most medical payers don’t support CPT or HCPCS procedure codes in eligibility requests. Instead, they expect a Service Type Code (STC).

If you send a procedure code to most medical payers, they'll return a fallback response for STC 30 or nothing at all.

Note: Many dental payers do support CDT procedure codes in eligibility checks. CDT codes aren’t included in our lookup tool for that reason.

The mapping problem

There's no standard mapping between procedure codes and STCs. Payers don't publish their mappings. The right STC can vary based on provider type, place of service, or other factors.

Figuring out which STC to use requires testing. See our Test payer STC support docs for guidance.

How the lookup tool works

The CPT/HCPCS to STC lookup tool gives you a set of STC candidates to test with each payer for a given CPT or HCPCS code.

The tool uses mappings from our STCs and procedure codes docs.

Tip: The tool returns STCs to test, not definitive mappings. Always test STCs with a payer before using them in production eligibility checks.

Request new mappings

If the tool doesn’t return an STC mapping for a CPT or HCPCS code you submit, you can request a new mapping at https://www.stedi.com/request-stc-mapping.

Get started

The CPT/HCPCS to STC lookup tool is available for free at https://www.stedi.com/cpt-hcpcs-to-stc. No account required.

If you’d like to see how eligibility checks work with Stedi, sign up for our free Basic plan. You’ll get 100 free eligibility checks each month.