M codes: Medical services and quality measures
Medical services and the codes used to report quality measures.
Active HCPCS M codes
Each opens its own page with CMS’s full descriptor, Medicare indicators and dates.
M0001Advancing cancer care mips value pathwaysM0002Optimal care for kidney health mips value pathwaysM0004Quality care for patients with neurological conditions mips value pathwayM0005Value in primary care mips value pathwayM0010Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom…M0075Cellular therapyM0076ProlotherapyM0100Intragastric hypothermia using gastric freezingM0201Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a…M0224Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain…M0231Intravenous infusion, tocilizumabbavi, for hospitalized adult patients with covid-19 who…M0232Intravenous infusion, tocilizumabbavi, for hospitalized adult patients with covid-19 who…M0233Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19…M0234Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19…M0235Intravenous infusion, monoclonal antibody products with an indication for post-exposure…M0236Intravenous infusion, monoclonal antibody products with an indication for post-exposure…M0237Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19…M0238Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19…M0249Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2…M0250Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2…M0300Iv chelation therapy (chemical endarterectomy)M0301Fabric wrapping of abdominal aneurysmM1003Tb screening performed and results interpreted within twelve months prior to initiation…M1004Documentation of medical reason for not screening for tb or interpreting results (i.e.…M1005Tb screening not performed or results not interpreted, reason not givenM1006Disease activity not assessed, reason not givenM1007>=50% of total number of a patient's outpatient ra encounters assessedM1008<50% of total number of a patient's outpatient ra encounters assessedM1009Discharge/discontinuation of the episode of care documented in the medical recordM1010Discharge/discontinuation of the episode of care documented in the medical recordM1011Discharge/discontinuation of the episode of care documented in the medical recordM1012Discharge/discontinuation of the episode of care documented in the medical recordM1013Discharge/discontinuation of the episode of care documented in the medical recordM1014Discharge/discontinuation of the episode of care documented in the medical recordM1016Female patients unable to bear childrenM1018Patients with an active diagnosis or history of cancer (except basal cell and squamous…M1019Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached…M1020Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not…M1021Patient had only urgent care visits during the performance periodM1027Imaging of the head (ct or mri) was obtainedM1028Documentation of patients with primary headache diagnosis and imaging other than ct or…M1029Imaging of the head (ct or mri) was not obtained, reason not givenM1032Adults currently taking pharmacotherapy for oudM1034Adults who have at least 180 days of continuous pharmacotherapy with a medication…M1035Adults who are deliberately phased out of medication assisted treatment (mat) prior to…M1036Adults who have not had at least 180 days of continuous pharmacotherapy with a…M1037Patients with a diagnosis of lumbar spine region cancer at the time of the procedureM1038Patients with a diagnosis of lumbar spine region fracture at the time of the procedureM1039Patients with a diagnosis of lumbar spine region infection at the time of the procedureM1040Patients with a diagnosis of lumbar idiopathic or congenital scoliosisM1041Patient had cancer, acute fracture or infection related to the lumbar spine or patient…M1043Functional status was not measured by the oswestry disability index (odi version 2.1a)…M1045Functional status measured by the oxford knee score (oks) at one year (9 to 15 months)…M1046Functional status measured by the oxford knee score (oks) at one year (9 to 15 months)…M1049Functional status was not measured by the oswestry disability index (odi version 2.1a)…M1051Patient had cancer, acute fracture or infection related to the lumbar spine or patient…M1052Leg pain was not measured by the visual analog scale (vas) or numeric pain scale at one…M1054Patient had only urgent care visits during the performance periodM1055Aspirin or another antiplatelet therapy usedM1056Prescribed anticoagulant medication during the performance period, history of gi…M1057Aspirin or another antiplatelet therapy not used, reason not givenM1058Patient was a permanent nursing home resident at any time during the performance periodM1059Patient was in hospice or receiving palliative care at any time during the performance…M1060Patient died prior to the end of the performance periodM1067Hospice services for patient provided any time during the measurement periodM1068Adults who are not ambulatoryM1069Patient screened for future fall riskM1070Patient not screened for future fall risk, reason not givenM1106The start of an episode of care documented in the medical recordM1107Documentation stating patient has a diagnosis of a degenerative neurological condition…M1108Ongoing care not clinically indicated because the patient needed a home program only…M1109Ongoing care not medically possible because the patient was discharged early due to…M1110Ongoing care not possible because the patient self-discharged early (e.g., financial or…M1111The start of an episode of care documented in the medical recordM1112Documentation stating patient has a diagnosis of a degenerative neurological condition…M1113Ongoing care not clinically indicated because the patient needed a home program only…M1114Ongoing care not medically possible because the patient was discharged early due to…M1115Ongoing care not possible because the patient self-discharged early (e.g., financial or…M1116The start of an episode of care documented in the medical recordM1117Documentation stating patient has a diagnosis of a degenerative neurological condition…M1118Ongoing care not clinically indicated because the patient needed a home program only…M1119Ongoing care not medically possible because the patient was discharged early due to…M1120Ongoing care not possible because the patient self-discharged early (e.g., financial or…M1121The start of an episode of care documented in the medical recordM1122Documentation stating patient has a diagnosis of a degenerative neurological condition…M1123Ongoing care not clinically indicated because the patient needed a home program only…M1124Ongoing care not medically possible because the patient was discharged early due to…M1125Ongoing care not possible because the patient self-discharged early (e.g., financial or…M1126The start of an episode of care documented in the medical recordM1127Documentation stating patient has a diagnosis of a degenerative neurological condition…M1128Ongoing care not clinically indicated because the patient needed a home program only…M1129Ongoing care not medically possible because the patient was discharged early due to…M1130Ongoing care not possible because the patient self-discharged early (e.g., financial or…M1131Documentation stating patient has a diagnosis of a degenerative neurological condition…M1132Ongoing care not clinically indicated because the patient needed a home program only…M1133Ongoing care not medically possible because the patient was discharged early due to…M1134Ongoing care not possible because the patient self-discharged early (e.g., financial or…M1135The start of an episode of care documented in the medical recordM1141Functional status was not measured by the oxford knee score (oks) or the knee injury and…M1142Emergent casesM1143Initiated episode of rehabilitation therapy, medical, or chiropractic care for neck…M1146Ongoing care not clinically indicated because the patient needed a home program only…M1147Ongoing care not medically possible because the patient was discharged early due to…M1148Ongoing care not possible because the patient self-discharged early (e.g., financial or…M1149Patient unable to complete the neck fs prom at initial evaluation and/or discharge due…M1150Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or…M1151Patients with a history of heart transplant or with a left ventricular assist device…M1152Patients with a history of heart transplant or with a left ventricular assist device…M1153Patient with diagnosis of osteoporosis on date of encounterM1159Hospice services provided to patient any time during the measurement periodM1160Patient had anaphylaxis due to the meningococcal vaccine any time on or before the…M1161Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on…M1162Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on…M1163Patient had anaphylaxis due to the hpv vaccine any time on or before the patient's 13th…M1164Patients with dementia any time during the patient's history through the end of the…M1165Patients who use hospice services any time during the measurement periodM1166Pathology report for tissue specimens produced from wide local excisions or re-excisionsM1167In hospice or using hospice services during the measurement periodM1168Patient received an influenza vaccine on or between july 1 of the year prior to the…M1169Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior…M1170Patient did not receive an influenza vaccine on or between july 1 of the year prior to…M1171Patient received at least one td vaccine or one tdap vaccine between nine years prior to…M1172Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior…M1173Patient did not receive at least one td vaccine or one tdap vaccine between nine years…M1174Patient received at least two doses of the herpes zoster recombinant vaccine (at least…M1175Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior…M1176Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28…M1177Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their…M1178Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g.…M1179Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or…M1180Patients on immune checkpoint inhibitor therapyM1181Grade 2 or above diarrhea and/or grade 2 or above colitisM1182Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g.…M1183Documentation of immune checkpoint inhibitor therapy held and corticosteroids or…M1184Documentation of medical reason(s) for not prescribing or administering corticosteroid…M1185Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or…M1186Patients who have an order for or are receiving hospice or palliative careM1187Patients with a diagnosis of end stage renal disease (esrd)M1188Patients with a diagnosis of chronic kidney disease (ckd) stage 5M1189Documentation of a kidney health evaluation defined by an estimated glomerular…M1190Documentation of a kidney health evaluation was not performed or defined by an estimated…M1191Hospice services provided to patient any time during the measurement periodM1192Patients with an existing diagnosis of squamous cell carcinoma of the esophagusM1193Surgical pathology reports that contain impression or conclusion of or recommendation…M1194Documentation of medical reason(s) surgical pathology reports did not contain impression…M1195Surgical pathology reports that do not contain impression or conclusion of or…M1196Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or…M1197Itch severity assessment score is reduced by 3 or more points from the initial (index)…M1198Itch severity assessment score was not reduced by at least 3 points from initial (index)…M1199Patients receiving rrtM1200Ace inhibitor (ace-i) or arb therapy prescribed during the measurement periodM1201Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb…M1202Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy…M1203Ace inhibitor or arb therapy not prescribed during the measurement period, reason not…M1204Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or…M1205Itch severity assessment score is reduced by 3 or more points from the initial (index)…M1206Itch severity assessment score was not reduced by at least 3 points from initial (index)…M1207Patient is screened for food insecurity, housing instability, transportation needs…M1208Patient is not screened for food insecurity, housing instability, transportation needs…M1209At least two orders for high-risk medications from the same drug class, (table 4)…M1210At least two orders for high-risk medications from the same drug class, (table 4), not…M1211Most recent glycemic status assessment (hba1c or gmi) level > 9.0%M1212Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during…M1213No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and…M1214Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and…M1215Documentation of medical reason(s) for not documenting and reviewing spirometry results…M1216No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented…M1217Documentation of system reason(s) for not documenting and reviewing spirometry results…M1218Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)M1220Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or…M1221Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or…M1222Glaucoma plan of care not documented, reason not otherwise specifiedM1223Glaucoma plan of care documentedM1224Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention…M1225Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the…M1226Iop measurement not documented, reason not otherwise specifiedM1227Evidence-based therapy was prescribedM1228Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that…M1229Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that…M1230Patient has a reactive hcv antibody test and does not have a follow up hcv viral test…M1231Patient receives hcv antibody test with nonreactive resultM1232Patient receives hcv antibody test with reactive resultM1233Patient does not receive hcv antibody test or patient does receive hcv antibody test but…M1234Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does…M1235Documentation or patient report of hcv antibody test or hcv rna test which occurred…M1236Baseline mrs > 2M1237Patient reason for not screening for food insecurity, housing instability…M1238Documentation that administration of second recombinant zoster vaccine could not occur…M1239Patient did not respond to the question of patient felt heard and understood by this…M1240Patient did not respond to the question of patient felt this provider and team put my…M1241Patient did not respond to the question of patient felt this provider and team saw me as…M1242Patient did not respond to the question of patient felt this provider and team…M1243Patient provided a response other than "completely true" for the question of patient…M1244Patient provided a response other than "completely true" for the question of patient…M1245Patient provided a response other than "completely true" for the question of patient…M1246Patient provided a response other than "completely true" for the question of patient…M1247Patient responded "completely true" for the question of patient felt this provider and…M1248Patient responded "completely true" for the question of patient felt this provider and…M1249Patient responded "completely true" for the question of patient felt this provider and…M1250Patient responded as "completely true" for the question of patient felt heard and…M1251Patients for whom a proxy completed the entire hu survey on their behalf for any reason…M1252Patients who did not complete at least one of the four patient experience hu survey…M1253Patients who respond on the patient experience hu survey that they did not receive care…M1254Patients who were deceased when the hu survey reached themM1255Patients who have another reason for visiting the clinic [not prenatal or postpartum…M1256Prior history of known cvdM1257Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not…M1258Cvd risk assessment performed, have a documented calculated risk scoreM1259Patient status documented within the first year of initiating dialysisM1260Patient status not documented within the first year of initiating dialysisM1261Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of…M1262Patients who had a transplant prior to initiation of dialysisM1263Patients in hospice on their initiation of dialysis date or during the month of evaluationM1265Cms medical evidence form 2728 for dialysis patients: initial form completedM1266Patients admitted to a skilled nursing facility (snf)M1267Patients not observed in active status on any kidney or kidney-pancreas transplant…M1268Patients observed in active status on any kidney or kidney-pancreas transplant waitlist…M1269Receiving esrd mcp dialysis services by the provider on the last day of the reporting…M1270Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of…M1271Patients with dementia at any time prior to or during the monthM1272Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last…M1273Patients who were admitted to a skilled nursing facility (snf) within one year of…M1274Patients who were admitted to a skilled nursing facility (snf) during the month of…M1275Patients determined to be in hospice were excluded from month of evaluation and the…M1276Bmi documented outside normal parameters, no follow-up plan documented, no reason givenM1277Colorectal cancer screening results documented and reviewedM1278Elevated or hypertensive blood pressure reading documented, and the indicated follow-up…M1279Elevated or hypertensive blood pressure reading documented, indicated follow-up not…M1280Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or…M1281Blood pressure reading not documented, reason not givenM1282Patient screened for tobacco use and identified as a tobacco non-userM1283Patient screened for tobacco use and identified as a tobacco userM1284Patients age 66 or older in institutional special needs plans (snp) or residing in long…M1285Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography…M1286Bmi is documented as being outside of normal parameters, follow-up plan is not completed…M1287Bmi is documented below normal parameters and a follow-up plan is documentedM1288Documented reason for not screening or recommending a follow-up for high blood pressureM1289Patient identified as tobacco user did not receive tobacco cessation intervention during…M1290Patient not eligible due to active diagnosis of hypertensionM1291Patients 66 years of age and older with at least one claim/encounter for frailty during…M1292Patients 66 years of age and older with at least one claim/encounter for frailty during…M1293Bmi is documented above normal parameters and a follow-up plan is documentedM1294Normal blood pressure reading documented, follow-up not requiredM1295Patients with a diagnosis or past history of total colectomy or colorectal cancerM1296Bmi is documented within normal parameters and no follow-up plan is requiredM1297Bmi not documented due to medical reason or patient refusal of height or weight…M1298Documentation of patient pregnancy anytime during the measurement period prior to and…M1299Influenza immunization administered or previously receivedM1300Influenza immunization was not administered for reasons documented by clinician (e.g.…M1301Patient identified as a tobacco user received tobacco cessation intervention during the…M1302Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography…M1303Hospice services provided to patient any time during the measurement periodM1304Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after…M1305Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their…M1306Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the…M1307Documentation stating the patient has received or is currently receiving palliative or…M1308Influenza immunization was not administered, reason not givenM1309Palliative care services provided to patient any time during the measurement periodM1310Patient screened for tobacco use and received tobacco cessation intervention during the…M1311Anaphylaxis due to the vaccine on or before the date of the encounterM1312Patient not screened for tobacco useM1313Tobacco screening not performed or tobacco cessation intervention not provided during…M1314Bmi not documented and no reason is givenM1315Colorectal cancer screening results were not documented and reviewed; reason not…M1316Current tobacco non-userM1317Patients who are counseled on connection with a csp and explicitly opt outM1318Patients who did not have documented contact with a csp for at least one of their…M1319Patients who had documented contact with a csp for at least one of their screened…M1320Patients who screened positive for at least 1 of the 5 hrsnsM1321Patients who were not seen within 7 weeks following the date of injection for follow up…M1322Patients seen within 7 weeks following the date of injection and are screened for…M1323Patients seen within 7 weeks following the date of injection and are screened for…M1324Patients who had an intravitreal or periocular corticosteroid injection (e.g.…M1325Patients who were not seen for reasons documented by clinician for patient or medical…M1326Patients with a diagnosis of hypotonyM1327Patients who were not appropriately evaluated during the initial exam and/or who were…M1328Patients with a diagnosis of acute vitreous hemorrhageM1329Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks…M1330Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate…M1331Patients who were appropriately evaluated during the initial exam and were re-evaluated…M1332Patients who were not appropriately evaluated during the initial exam and/or who were…M1333Acute vitreous hemorrhageM1334Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks…M1335Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate…M1336Patients who were appropriately evaluated during the initial exam and were re-evaluated…M1337Acute pvdM1338Patients who had follow-up assessment 30 to 180 days after the index assessment who did…M1339Patients who had follow-up assessment 30 to 180 days after the index assessment who…M1340Index assessment completed using the 12-item whodas 2.0 or sds during the denominator…M1341Patients who did not have a follow-up assessment or did not have an assessment within 30…M1342Patients who died during the performance periodM1343Patients who are at pam level 4 at baseline or patients who are flagged with extreme…M1344Patients who did not have a baseline pam score and/or a second score within 4 to 12…M1345Patients who had a baseline pam score and a second score within 4 to 12 month of…M1346Patients who did not have a net increase in pam score of at least 6 points within a 4 to…M1347Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12…M1348Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12…M1349Patients who did not have a net increase in pam score of at least 3 points within a 4 to…M1350Patients who had a completed suicide safety plan initiated, reviewed or updated in…M1351Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and…M1352Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessmentM1353Patients who did not have a completed suicide safety plan initiated, reviewed or updated…M1354Patients who did not have a suicide safety plan initiated, reviewed, or updated or…M1355Suicide risk based on their clinician's evaluation or a clinician-rated toolM1356Patients who died during the measurement periodM1357Patients who had a reduction in suicidal ideation and/or behavior upon follow-up…M1358Patients who did not have a reduction in suicidal ideation and/or behavior upon…M1359Index assessment during the denominator period when the suicidal ideation and/or…M1360Suicidal ideation and/or behavior symptoms based on the c-ssrsM1361Suicide risk based on their clinician's evaluation or a clinician-rated toolM1362Patients who died during the measurement periodM1363Patients who did not have a follow-up assessment within 120 days of the index assessmentM1364Calculated 10-year ascvd risk score of >= 20 percent during the performance periodM1365Patient encounter during the performance period with hospice and palliative care…M1366Focusing on women's health mips value pathwayM1367Quality care for the treatment of ear, nose, and throat disorders mips value pathwayM1368Prevention and treatment of infectious disorders including hepatitis c and hiv mips…M1369Quality care in mental health and substance use disorders mips value pathwayM1370Rehabilitative support for musculoskeletal care mips value pathwayM1371Most recent glycemic status assessment (hba1c or gmi) level < 7.0%M1372Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%M1373Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%M1374An additional encounter with an ra diagnosis during the performance period or prior…M1375An additional encounter with an ra diagnosis during the performance period or prior…M1376An additional encounter with an ra diagnosis during the performance period or prior…M1377Recommended follow-up interval for repeat colonoscopy of 10 years documented in…M1378Documentation of medical reason(s) for not recommending a 10 year follow-up interval…M1379A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise…M1380Filled at least two prescriptions during the performance period for any combination of…M1381Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm…M1382Patient encounter during the performance period with place of service code 11M1383Acute pvdM1384Patients who died during the performance periodM1385Documentation of patient reasons for patients who were not seen for the second pam…M1386Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years…M1387Patients who died during the performance periodM1388Patients with documentation of an exam performed for recurrence of melanomaM1390Patients who do not have a documented exam performed for recurrence of melanoma or no…M1391All patients who were diagnosed with recurrent melanoma during the current performance…M1392Documentation of patient reasons for no examination, i.e., refusal of examination or…M1393Patients who were not diagnosed with recurrent melanoma during the current performance…M1394Stages i-iii breast cancerM1395Patients receiving an initial chemotherapy regimen with a defined duration with the…M1396Patients on a therapeutic clinical trialM1397Patients with recurrence/disease progressionM1398Patients with baseline and follow-up promis surveys documented in the medical recordM1399Patients who leave the practice during the follow-up periodM1400Patients who died during the follow-up periodM1401Stages i-iii breast cancerM1402Patients receiving an initial chemotherapy regimen with a defined duration with the…M1403Patients with baseline and follow-up promis surveys documented in the medical recordM1404Patients on a therapeutic clinical trialM1405Patients with recurrence/disease progressionM1406Patients who leave the practice during the follow-up periodM1407Patients who died during the follow-up periodM1408Patients who have germline brca testing completed before diagnosis of epithelial…M1409Patients who received germline testing for brca1 and brca2 or genetic counseling…M1410Patients who did not have germline testing for brca1 and brca2 or genetic counseling…M1411Currently on first-line immune checkpoint inhibitors without chemotherapyM1412Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations…M1413Patients who had a positive pd-l1 biomarker expression test result prior to the…M1414Documentation of medical reason(s) for not performing the pd-l1 biomarker expression…M1415Patients who did not have a positive pd-l1 biomarker expression test result prior to the…M1416Patient received hospice services any time during the performance periodM1417Patients who are up to date on their covid-19 vaccinations as defined by cdc…M1418Patients who are not up to date on their covid-19 vaccinations as defined by cdc…M1419Patients who are not up to date on their covid-19 vaccinations as defined by cdc…M1420Complete ophthalmologic care mips value pathwayM1421Dermatological care mips value pathwayM1422Gastroenterology care mips value pathwayM1423Optimal care for patients with urologic conditions mips value pathwayM1424Pulmonology care mips value pathwayM1425Surgical care mips value pathwayM1426Encounters conducted via telehealthM1427Documentation of medical reason(s) for performing a bone scan (including documented pain…M1428Patients who have bilateral absence of eyes any time during the patient's history…M1429Retinal exam finding with evidence of retinopathy in left, right or both eyes with…M1430Retinal exam finding without evidence of retinopathy in both eyes with severity level…M1431Encounters conducted via telehealthM1432Encounters conducted via telehealthM1433Patient on oral chemotherapy on or within 30 days before denominator eligible encounterM1434Patient on oral chemotherapy on or within 30 days after denominator eligible encounterM1435Patient on oral chemotherapy during the performance periodM1436Encounters conducted via telehealthM1437Encounters conducted via telehealthM1438Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)M1439Significant ocular conditions that impact the visual outcome of surgeryM1440Encounters conducted via telehealthM1441Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep…M1442Encounters conducted via telehealthM1443Encounters conducted via telehealthM1444Delivery at < 39 weeks of gestationM1445Postpartum care visit before or at 12 weeks of giving birthM1446Patients who died any time prior to the end of the measure assessment periodM1447Patients with an active diagnosis of bipolar disorder any time prior to the end of the…M1448Patients with an active diagnosis of personality disorder any time prior to the end of…M1449Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior…M1450Patients who received hospice or palliative care service any time during denominator…M1451Patients with an active diagnosis of pervasive developmental disorder any time prior to…M1452Patient ever had a diagnosis of dementiaM1453Patients with a pre-operative visual acuity better than 20/40M1454New ciedM1455Replaced or revised ciedM1456Patient had a heart transplantM1457Patient had a diagnosis of asthma with any contact during the current or prior…M1458Patient died prior to the end of the performance periodM1459Patient was in hospice or receiving palliative care services at any time during the…M1460Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or…M1461Patient diagnosis for chronic hepatitis cM1462Patients with clinical indications for imaging of the headM1463Documentation of at least two attempts to follow up with patient within 180 days of…M1464No documentation of at least two attempts to follow up with patient within 180 days of…M1465Patient follow up more than 180 days after treatmentM1466Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedureM1467Patients with an existing diagnosis of lynch syndromeM1468Patient received recommended doses of hepatitis b vaccination based on ageM1469Patient has a history of hepatitis b illness or received a hepatitis b surface antigen…M1470Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g.…M1471Documentation that patient is a medicare fee-for-service beneficiary and without…M1472Patient did not receive recommended doses of hepatitis b vaccination based on ageM1473Patient situations, at any point during the denominator identification period, where the…M1474Patients with diagnosis of dementiaM1475Patients with diagnosis of huntington's diseaseM1476Patients with diagnosis of cognitive impairment or alzheimer's diseaseM1477Diagnosis of deliriumM1478Psychoactive substance abuseM1479Patients whose functional capacity or motivation (or lack thereof) to improve may impact…M1480Patients whose functional capacity or motivation (or lack thereof) to improve may impact…M1481Patients receiving hospice or palliative care or who died during the measurement periodM1482Positive/detectable hepatitis c virus quantitative or qualitative rna test result during…M1483Patients who achieve sustained virological response as identified by an hcv rna test…M1484Patients who did not have a repeat hcv rna labs performed for medical reasons documented…M1485Patients who did not achieve sustained virological response as identified by an hcv rna…M1486Patients admitted to a skilled nursing facility (snf) during the period of evaluationM1487Patients in hospice in the year before or during the period of evaluationM1488Patients with a diagnosis for dementia in the year before or during the period of…M1489Patient status documentedM1490Patient status not documentedM1491Receiving esrd mcp dialysis services by the provider during the performance periodM1492Patients who did not report a fallM1493Documentation of falls not performed due to medical reasons (e.g., syncope, vertigo and…M1494Patients that reported a fall since the last visitM1495Patients that reported a fall occurred who had a plan of care for falls documented or…M1496Patients that had a fall who did not have a plan of care for falls documented or do not…M1497Documentation of falls not performed due to medical reasons (e.g., syncope, vertigo and…M1498Diagnostic radiology mips value pathwayM1499Interventional radiology mips value pathwayM1500Neuropsychology mips value pathwayM1501Pathology mips value pathwayM1502Podiatry mips value pathwayM1503Vascular surgery mips value pathway
Terminated HCPCS M codes
Codes CMS has ended, kept for looking up older claims. Each page gives its last date of service.
Source and release
- Data release
- HCPCS Level II · October 2026
- Effective date
- Oct 1, 2026
- Publisher
- CMS
This list is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes, imported from CMS’s October 2026 HCPCS file and checked against it.
Frequently asked questions
What are HCPCS M codes?
HCPCS M codes cover medical services and the codes used to report quality measures.
How many HCPCS M codes are there?
CMS’s October 2026 HCPCS file lists 451 active HCPCS M codes, and 55 more that it has terminated.
Are terminated HCPCS M codes listed?
Yes, after the active codes, each with its last date of service, for looking up older claims. A terminated code can’t be used for newer services.