HCPCS M-Codes
Medical services

  • M0001

    Advancing cancer care mips value pathways   New

  • M0002

    Optimal care for kidney health mips value pathways   New

  • M0003

    Optimal care for patients with episodic neurological conditions mips value pathways   New

  • M0004

    Supportive care for neurodegenerative conditions mips value pathways   New

  • M0005

    Promoting wellness mips value pathways   New

  • M0064

    Brief office visit for the sole purpose of monitoring or changing drug prescriptions used in the treatment of mental psychoneurotic and personality disorders

  • M0075

    Cellular therapy

  • M0076

    Prolotherapy

  • M0100

    Intragastric hypothermia using gastric freezing

  • M0201

    Covid-19 vaccine administration inside a patient's home; reported only once per individual home per date of service when only covid-19 vaccine administration is performed at the patient's home
  • Continued

  • M0220

    Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), includes injection and post administration monitoring

  • M0221

    Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), includes injection and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency

  • M0222

    Intravenous injection, bebtelovimab, includes injection and post administration monitoring

  • M0223

    Intravenous injection, bebtelovimab, includes injection and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency

  • M0239

    Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring

  • M0240

    Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring, subsequent repeat doses

  • M0241

    Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency, subsequent repeat doses

  • M0243

    Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring

  • M0244

    Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency

  • M0245

    Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring

  • M0246

    Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider based to the hospital during the covid 19 public health emergency

  • M0247

    Intravenous infusion, sotrovimab, includes infusion and post administration monitoring

  • M0248

    Intravenous infusion, sotrovimab, includes infusion and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency

  • M0249

    Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administration monitoring, first dose

  • M0250

    Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administration monitoring, second dose

  • M0300

    Iv chelation therapy (chemical endarterectomy)

  • M0301

    Fabric wrapping of abdominal aneurysm

  • M1000

    Pain screened as moderate to severe

  • M1001

    Plan of care to address moderate to severe pain documented on or before the date of the second visit with a clinician

  • M1002

    Plan of care for moderate to severe pain not documented on or before the date of the second visit with a clinician, reason not given
  • Continued

  • M1003

    Tb screening performed and results interpreted within twelve months prior to initiation of first-time biologic and/or immune response modifier therapy

  • M1004

    Documentation of medical reason for not screening for tb or interpreting results (i.e., patient positive for tb and documentation of past treatment; patient who has recently completed a course of anti-tb therapy)

  • M1005

    Tb screening not performed or results not interpreted, reason not given

  • M1006

    Disease activity not assessed, reason not given

  • M1007

    >=50% of total number of a patient's outpatient ra encounters assessed

  • M1008

    <50% of total number of a patient's outpatient ra encounters assessed

  • M1009

    Discharge/discontinuation of the episode of care documented in the medical record

  • M1010

    Discharge/discontinuation of the episode of care documented in the medical record

  • M1011

    Discharge/discontinuation of the episode of care documented in the medical record

  • M1012

    Discharge/discontinuation of the episode of care documented in the medical record

  • M1013

    Discharge/discontinuation of the episode of care documented in the medical record

  • M1014

    Discharge/discontinuation of the episode of care documented in the medical record

  • M1015

    Discharge/discontinuation of the episode of care documented in the medical record

  • M1016

    Female patients unable to bear children

  • M1017

    Patient admitted to palliative care services   Discontinued

  • M1018

    Patients with an active diagnosis or history of cancer (except basal cell and squamous cell skin carcinoma), patients who are heavy tobacco smokers, lung cancer screening patients

  • M1019

    Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5

  • M1020

    Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq-9 or phq-9m score was not assessed or is greater than or equal to 5

  • M1021

    Patient had only urgent care visits during the performance period

  • M1022

    Patients who were in hospice at any time during the performance period