M1197 HCPCS Level II code: Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score
M1197 is the HCPCS code for “Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
M1197Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score
Short description: Isa reduced >=3 fr ixv
HCPCS · United States
Medicare details
The indicators CMS publishes with M1197 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, 2023
Where M1197 sits
- 1M codesMedical services and quality measures
- 2Active code M1197Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score
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 M1197 mean?
M1197 is the HCPCS code for “Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover M1197?
CMS lists M1197’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 M1197
All M codesM1191Hospice 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 for testing of mmr by immunohistochemistry, msi by dna-based testing status, or bothM1194Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by…M1195Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both…M1196Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4M1198Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up…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 therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other…M1202Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)M1203Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given