M1108 HCPCS Level II code: Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as…

M1108 is the HCPCS code for “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” in CMS’s October 2026 release, in effect from Oct 1, 2026.

Official description

M1108

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

Short description: Oc ni pt home prog

HCPCS · United States

Medicare details

The indicators CMS publishes with M1108 in its October 2026 file. They describe Medicare’s handling, not another payer’s.

Medicare coverage
Carrier judgment
Medicare pricing
Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)
Type of service
Medical care
BETOS category
Undefined codes
Added
Jan 1, 2020

Where M1108 sits

  1. 1M codesMedical services and quality measures
  2. 2Active code M1108Ongoing 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

Source and release

Data release
HCPCS Level II · October 2026
Effective date
Oct 1, 2026
Publisher
CMS

This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.

Frequently asked questions

What does HCPCS code M1108 mean?

M1108 is the HCPCS code for “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” in CMS’s HCPCS Level II October 2026 release.

Does Medicare cover M1108?

CMS lists M1108’s Medicare coverage as “Carrier judgment” and its pricing as “Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.

Which HCPCS Level II release does this page use?

It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.