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• M1249

  Patient responded "completely true" for the question of patient felt this provider and team understood what is important to me in my life

• M1250

  Patient responded as "completely true" for the question of patient felt heard and understood by this provider and team

• M1251

  Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)

• M1252

  Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit

• M1253

  Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)

• M1254

  Patients who were deceased when the hu survey reached them

• M1255

  Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)

• M1256

  Prior history of known cvd

• M1257

  Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified

• M1258

  Cvd risk assessment performed, have a documented calculated risk score

• M1259

  Patient status documented within the first year of initiating dialysis

• M1260

  Patient status not documented within the first year of initiating dialysis

• M1261

  Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis

• M1262

  Patients who had a transplant prior to initiation of dialysis

• M1263

  Patients in hospice on their initiation of dialysis date or during the month of evaluation

• M1264

  Patients age 75 or older on their initiation of dialysis date

• M1265

  Cms medical evidence form 2728 for dialysis patients: initial form completed

• M1266

  Patients admitted to a skilled nursing facility (snf)

• M1267

  Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period

• M1268

  Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period

• M1269

  Receiving esrd mcp dialysis services by the provider on the last day of the reporting month

• M1270

  Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period

• M1271

  Patients with dementia at any time prior to or during the month

• M1272

  Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period

• M1273

  Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form

• M1274

  Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month

• M1275

  Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period

• M1276

  Bmi documented outside normal parameters, no follow-up plan documented, no reason given

• M1277

  Colorectal cancer screening results documented and reviewed

• M1278

  Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented

• M1279

  Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given

• M1280

  Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy

• M1281

  Blood pressure reading not documented, reason not given

• M1282

  Patient screened for tobacco use and identified as a tobacco non-user

• M1283

  Patient screened for tobacco use and identified as a tobacco user

• M1284

  Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period

• M1285

  Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified

• M1286

  Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason

• M1287

  Bmi is documented below normal parameters and a follow-up plan is documented

• M1288

  Documented reason for not screening or recommending a follow-up for high blood pressure

• M1289

  Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)

• M1290

  Patient not eligible due to active diagnosis of hypertension

• M1291

  Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period

• M1292

  Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period

• M1293

  Bmi is documented above normal parameters and a follow-up plan is documented

• M1294

  Normal blood pressure reading documented, follow-up not required

• M1295

  Patients with a diagnosis or past history of total colectomy or colorectal cancer

• M1296

  Bmi is documented within normal parameters and no follow-up plan is required

• M1297

  Bmi not documented due to medical reason or patient refusal of height or weight measurement

• M1298

  Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter

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HCPCS Level II codes and descriptors are approved and maintained jointly by the alpha-numeric editorial panel (consisting of CMS, the Health Insurance Association of America, and the Blue Cross and Blue Shield Association). — Updated 6/3/2026

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