M1138 HCPCS Level II code: Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only)
CMS terminated M1138: its last date of service was Dec 31, 2020. It stays here for looking up older claims; newer services need a current code.
Official description
M1138Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only)
Short description: Oc ni pt 1-2 vis
HCPCS · United States
Medicare details
The indicators CMS publishes with M1138 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
- Terminated after
- Dec 31, 2020
Where M1138 sits
- 1M codesMedical services and quality measures
- 2Terminated M1138Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only)
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
Is HCPCS code M1138 still valid?
No. CMS terminated M1138; its last date of service was Dec 31, 2020. It is listed for looking up services from before then. Use a current code for newer services.
Does Medicare cover M1138?
CMS lists M1138’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.
Codes beside M1138
All M codesM1132Ongoing 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…M1133Ongoing 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…M1134Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)M1135The start of an episode of care documented in the medical recordM1136The start of an episode of care documented in the medical recordM1137Documentation 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 careM1139Ongoing care not indicated, patient self-discharged early and seen only 1-2 visits (e.g., financial or insurance reasons, transportation problems, or reason unknown)M1140Ongoing 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…M1141Functional 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)…M1142Emergent casesM1143Initiated episode of rehabilitation therapy, medical, or chiropractic care for neck impairmentM1144Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only