M1238 HCPCS Level II code: Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval…
M1238 is the HCPCS code for “Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received…” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
M1238Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)
Short description: Doc 2nd recom hzv 2-6 mo int
HCPCS · United States
Medicare details
The indicators CMS publishes with M1238 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 M1238 sits
- 1M codesMedical services and quality measures
- 2Active code M1238Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)
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 M1238 mean?
M1238 is the HCPCS code for “Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover M1238?
CMS lists M1238’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 M1238
All M codesM1232Patient 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 > 2M1237Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other…M1239Patient did not respond to the question of patient felt heard and understood by this provider and teamM1240Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my careM1241Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problemM1242Patient did not respond to the question of patient felt this provider and team understood what is important to me in my lifeM1243Patient provided a response other than "completely true" for the question of patient felt heard and understood by this provider and teamM1244Patient provided a response other than "completely true" for the question of patient felt this provider and team put my best interests first when making recommendations about my…