HCPCS Service Codes - Medical care

HCPCS Service Code 1 for Medical care.

HCPCS Type of Service (TOS) code is an indicator that the contractor places on Form CMS-1500. The indicator is mainly used for data purposes, however in some instances, it affects payment. All HCPCS codes have a corresponding TOS indicator.

Below are all available HCPCS TOS codes. Find an HCPCS code based on the type of service.

HCPCS Codes for Medical care

  • M1119

    Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery

  • M1120

    Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)

  • M1121

    The start of an episode of care documented in the medical record

  • M1122

    Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care

  • M1123

    Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record

  • M1124

    Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery

  • M1125

    Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)

  • M1126

    The start of an episode of care documented in the medical record

  • M1127

    Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care

  • M1128

    Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record

  • M1129

    Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery

  • M1130

    Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)

  • M1131

    Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care

  • M1132

    Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record

  • M1133

    Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery

  • M1134

    Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)

  • M1135

    The start of an episode of care documented in the medical record

  • M1136

    The start of an episode of care documented in the medical record

  • M1137

    Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care

  • M1138

    Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only)

  • M1139

    Ongoing care not indicated, patient self-discharged early and seen only 1-2 visits (e.g., financial or insurance reasons, transportation problems, or reason unknown)

  • M1140

    Ongoing care not indicated, patient discharged after only 1-2 visits due to specific medical events, documented in the medical record that make the treatment episode impossible such as the patient becomes hospitalized or scheduled for surgery for surgery or hospitalized

  • M1141

    Functional status was not measured by the oxford knee score (oks) or the knee injury and osteoarthritis outcome score joint replacement (koos, jr.) at one year (9 to 15 months) postoperatively

  • M1142

    Emergent cases

  • M1143

    Initiated episode of rehabilitation therapy, medical, or chiropractic care for neck impairment

  • M1144

    Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only

  • M1145

    Most favored nation (mfn) model drug add-on amount, per dose, (do not bill with line items that have the jw modifier)

  • M1146

    Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record

  • M1147

    Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery

  • M1148

    Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)

  • M1149

    Patient unable to complete the neck fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility, and an adequate proxy is not available

  • M1150

    Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function

  • M1151

    Patients with a history of heart transplant or with a left ventricular assist device (lvad)

  • M1152

    Patients with a history of heart transplant or with a left ventricular assist device (lvad)

  • M1153

    Patient with diagnosis of osteoporosis on date of encounter

  • M1154

    Hospice services provided to patient any time during the measurement period

  • M1155

    Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period

  • M1156

    Patient received active chemotherapy any time during the measurement period

  • M1157

    Patient received bone marrow transplant any time during the measurement period

  • M1158

    Patient had history of immunocompromising conditions prior to or during the measurement period

  • M1159

    Hospice services provided to patient any time during the measurement period

  • M1160

    Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patient's 13th birthday

  • M1161

    Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday

  • M1162

    Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday

  • M1163

    Patient had anaphylaxis due to the hpv vaccine any time on or before the patient's 13th birthday

  • M1164

    Patients with dementia any time during the patient's history through the end of the measurement period

  • M1165

    Patients who use hospice services any time during the measurement period

  • M1166

    Pathology report for tissue specimens produced from wide local excisions or re-excisions

  • M1167

    In hospice or using hospice services during the measurement period

  • M1168

    Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period