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

  • M1470

    Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)

  • M1471

    Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules

  • M1472

    Patient did not receive recommended doses of hepatitis b vaccination based on age

  • M1473

    Patient situations, at any point during the denominator identification period, where the patient's functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders

  • M1474

    Patients with diagnosis of dementia

  • M1475

    Patients with diagnosis of huntington's disease

  • M1476

    Patients with diagnosis of cognitive impairment or alzheimer's disease

  • M1477

    Diagnosis of delirium

  • M1478

    Psychoactive substance abuse

  • M1479

    Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders

  • M1480

    Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders

  • M1481

    Patients receiving hospice or palliative care or who died during the measurement period

  • M1482

    Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period

  • M1483

    Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period

  • M1484

    Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)

  • M1485

    Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period

  • M1486

    Patients admitted to a skilled nursing facility (snf) during the period of evaluation

  • M1487

    Patients in hospice in the year before or during the period of evaluation

  • M1488

    Patients with a diagnosis for dementia in the year before or during the period of evaluation

  • M1489

    Patient status documented

  • M1490

    Patient status not documented

  • M1491

    Receiving esrd mcp dialysis services by the provider during the performance period

  • M1492

    Patients who did not report a fall

  • M1493

    Documentation of falls not performed due to medical reasons (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)

  • M1494

    Patients that reported a fall since the last visit

  • M1495

    Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall

  • M1496

    Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls

  • M1497

    Documentation of falls not performed due to medical reasons (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)

  • M1498

    Diagnostic radiology mips value pathway

  • M1499

    Interventional radiology mips value pathway

  • M1500

    Neuropsychology mips value pathway

  • M1501

    Pathology mips value pathway

  • M1502

    Podiatry mips value pathway

  • M1503

    Vascular surgery mips value pathway

  • Q0081

    Infusion therapy, using other than chemotherapeutic drugs, per visit

  • Q0083

    Chemotherapy administration by other than infusion technique only (e.g., subcutaneous, intramuscular, push), per visit

  • Q0084

    Chemotherapy administration by infusion technique only, per visit

  • Q0085

    Chemotherapy administration by both infusion technique and other technique(s) (e.g., subcutaneous, intramuscular, push), per visit

  • Q0091

    Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory

  • Q0138

    Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use)

  • Q0139

    Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (for esrd on dialysis)

  • Q0144

    Azithromycin dihydrate, oral, capsules/powder, 1 gram

  • Q0155

    Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen

  • Q0161

    Chlorpromazine hydrochloride, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen

  • Q0162

    Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen

  • Q0163

    Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen

  • Q0164

    Prochlorperazine maleate, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen

  • Q0166

    Granisetron hydrochloride, 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen

  • Q0167

    Dronabinol, 2.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen

  • Q0169

    Promethazine hydrochloride, 12.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen