M1284 HCPCS Level II code: Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90…
M1284 is the HCPCS code for “Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
M1284Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period
Short description: Pt 66+ snp or ltc pos > 90d
HCPCS · United States
Medicare details
The indicators CMS publishes with M1284 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 M1284 sits
- 1M codesMedical services and quality measures
- 2Active code M1284Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period
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 M1284 mean?
M1284 is the HCPCS code for “Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover M1284?
CMS lists M1284’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 M1284
All M codesM1278Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documentedM1279Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not givenM1280Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomyM1281Blood pressure reading not documented, reason not givenM1282Patient screened for tobacco use and identified as a tobacco non-userM1283Patient screened for tobacco use and identified as a tobacco userM1285Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specifiedM1286Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reasonM1287Bmi is documented below normal parameters and a follow-up plan is documentedM1288Documented reason for not screening or recommending a follow-up for high blood pressureM1289Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling…M1290Patient not eligible due to active diagnosis of hypertension