HCPCS Code M1209

At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses
Code effective Jan 01, 2023

HCPCS Section
Medical services

M1209 is a valid 2026 HCPCS code meaning At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses or (>=2 same hi-rsk med w/o diag) for short. HCPCS M1209 has been effective since 01/01/2023 and applies to Medical care.

HCPCS Code Details - M1209

HCPCS Level II Code
Section M - Medical services
HCPCS Code M1209
Description

Long description:
At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses

Short description:
>=2 same hi-rsk med w/o diag

HCPCS Pricing indicator 00 - Physician Fee Schedule And Non-Physician Practitioners - Service not separately priced by part B (e.g., services not covered, bundled, used by Part A only, etc.)
Multiple pricing indicator 9 - Not applicable as HCPCS not priced separately by part B or value is not established
Coverage code C - Carrier judgment
BETOS2 code Z2 - Undefined codes
HCPCS Action code N - No maintenance for this code
Type of service 1 - Medical care
Effective date Effective Jan 01, 2023
Date added Added Jan 01, 2023

See also

  • HCPCS M1208 · Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety

  • HCPCS G9367 · At least two orders for high-risk medications from the same drug class

  • HCPCS G9368 · At least two orders for high-risk medications from the same drug class not ordered

  • HCPCS M1210 · At least two orders for high-risk medications from the same drug class, (table 4), not ordered

1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”

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 6/23/2026

CPT® is a registered trademark of the American Medical Association (AMA). All rights reserved.