M1204 HCPCS Level II code: Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4
M1204 is the HCPCS code for “Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
M1204Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4
Short description: Ixv nrs vrs iqa >=4
HCPCS · United States
Medicare details
The indicators CMS publishes with M1204 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 M1204 sits
- 1M codesMedical services and quality measures
- 2Active code M1204Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4
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 M1204 mean?
M1204 is the HCPCS code for “Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover M1204?
CMS lists M1204’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 M1204
All M codesM1198Itch 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 givenM1205Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit scoreM1206Itch 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…M1207Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safetyM1208Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safetyM1209At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnosesM1210At least two orders for high-risk medications from the same drug class, (table 4), not ordered