M1146 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…
M1146 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
M1146Ongoing 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: Ongoing care not ind
HCPCS · United States
Medicare details
The indicators CMS publishes with M1146 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, 2021
Where M1146 sits
- 1M codesMedical services and quality measures
- 2Active code M1146Ongoing 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 M1146 mean?
M1146 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 M1146?
CMS lists M1146’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 M1146
All M codesM1140Ongoing 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 onlyM1145Most favored nation (mfn) model drug add-on amount, per dose, (do not bill with line items that have the jw modifier)M1147Ongoing 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…M1148Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)M1149Patient 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…M1150Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic functionM1151Patients with a history of heart transplant or with a left ventricular assist device (lvad)M1152Patients with a history of heart transplant or with a left ventricular assist device (lvad)