HCPCS M-Codes
Medical services


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  • M1400

    Patients who died during the follow-up period
  • M1401

    Stages i-iii breast cancer
  • M1402

    Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group
  • M1403

    Patients with baseline and follow-up promis surveys documented in the medical record
  • M1404

    Patients on a therapeutic clinical trial
  • M1405

    Patients with recurrence/disease progression
  • M1406

    Patients who leave the practice during the follow-up period
  • M1407

    Patients who died during the follow-up period
  • M1408

    Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer
  • M1409

    Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis
  • M1410

    Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis
  • M1411

    Currently on first-line immune checkpoint inhibitors without chemotherapy
  • M1412

    Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skipping mutation, and ret rearrangement
  • M1413

    Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy
  • M1414

    Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patient's health status; other medical reasons/contraindication)
  • M1415

    Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy
  • M1416

    Patient received hospice services any time during the performance period
  • M1417

    Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination
  • M1418

    Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician
  • M1419

    Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination
  • M1420

    Complete ophthalmologic care mips value pathway
  • M1421

    Dermatological care mips value pathway
  • M1422

    Gastroenterology care mips value pathway
  • M1423

    Optimal care for patients with urologic conditions mips value pathway
  • M1424

    Pulmonology care mips value pathway
  • M1425

    Surgical care mips value pathway
  • M1426

    Encounters conducted via telehealth
  • M1427

    Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)
  • M1428

    Patients who have bilateral absence of eyes any time during the patient's history through the end of the measurement period
  • M1429

    Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented
  • M1430

    Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)
  • M1431

    Encounters conducted via telehealth
  • M1432

    Encounters conducted via telehealth
  • M1433

    Patient on oral chemotherapy on or within 30 days before denominator eligible encounter
  • M1434

    Patient on oral chemotherapy on or within 30 days after denominator eligible encounter
  • M1435

    Patient on oral chemotherapy during the performance period
  • M1436

    Encounters conducted via telehealth
  • M1437

    Encounters conducted via telehealth
  • M1438

    Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)
  • M1439

    Significant ocular conditions that impact the visual outcome of surgery
  • M1440

    Encounters conducted via telehealth
  • M1441

    Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient
  • M1442

    Encounters conducted via telehealth
  • M1443

    Encounters conducted via telehealth
  • M1444

    Delivery at < 39 weeks of gestation
  • M1445

    Postpartum care visit before or at 12 weeks of giving birth
  • M1446

    Patients who died any time prior to the end of the measure assessment period
  • M1447

    Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period
  • M1448

    Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period
  • M1449

    Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period

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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