M1230 HCPCS Level II code: Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv…
M1230 is the HCPCS code for “Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is…” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
M1230Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment initiated within 3 months of the reactive hcv antibody test, reason not given
Short description: Pt hcv rctv aby no f/u tst
HCPCS · United States
Medicare details
The indicators CMS publishes with M1230 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, 2024
Where M1230 sits
- 1M codesMedical services and quality measures
- 2Active code M1230Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment initiated within 3 months of the reactive hcv antibody test, reason not given
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 M1230 mean?
M1230 is the HCPCS code for “Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment initiated within 3 months of the reactive hcv antibody test, reason not given” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover M1230?
CMS lists M1230’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 M1230
All M codesM1224Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention levelM1225Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention levelM1226Iop measurement not documented, reason not otherwise specifiedM1227Evidence-based therapy was prescribedM1228Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv…M1229Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a…M1231Patient receives hcv antibody test with nonreactive resultM1232Patient receives hcv antibody test with reactive resultM1233Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not givenM1234Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremiaM1235Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance periodM1236Baseline mrs > 2