M1243 HCPCS Level II code: Patient provided a response other than "completely true" for the question of patient felt heard and understood by this provider and team

M1243 is the HCPCS code for “Patient provided a response other than "completely true" for the question of patient felt heard and understood by this provider and team” in CMS’s October 2026 release, in effect from Oct 1, 2026.

Official description

M1243

Patient provided a response other than "completely true" for the question of patient felt heard and understood by this provider and team

Short description: Pt othr thn true heard

HCPCS · United States

Medicare details

The indicators CMS publishes with M1243 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 M1243 sits

  1. 1M codesMedical services and quality measures
  2. 2Active code M1243Patient provided a response other than "completely true" for the question of patient felt heard and understood by this provider and team

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 M1243 mean?

M1243 is the HCPCS code for “Patient provided a response other than "completely true" for the question of patient felt heard and understood by this provider and team” in CMS’s HCPCS Level II October 2026 release.

Does Medicare cover M1243?

CMS lists M1243’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.

M1237Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other…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…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 lifeM1244Patient 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…M1245Patient provided a response other than "completely true" for the question of patient felt this provider and team saw me as a person, not just someone with a medical problemM1246Patient provided a response other than "completely true" for the question of patient felt this provider and team understood what is important to me in my lifeM1247Patient responded "completely true" for the question of patient felt this provider and team put my best interests first when making recommendations about my careM1248Patient responded "completely true" for the question of patient felt this provider and team saw me as a person, not just someone with a medical problemM1249Patient responded "completely true" for the question of patient felt this provider and team understood what is important to me in my life