M1290 HCPCS Level II code: Patient not eligible due to active diagnosis of hypertension
M1290 is the HCPCS code for “Patient not eligible due to active diagnosis of hypertension” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
M1290Patient not eligible due to active diagnosis of hypertension
Short description: Pt not eli d/t act dig htn
HCPCS · United States
Medicare details
The indicators CMS publishes with M1290 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 M1290 sits
- 1M codesMedical services and quality measures
- 2Active code M1290Patient not eligible due to active diagnosis of hypertension
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 M1290 mean?
M1290 is the HCPCS code for “Patient not eligible due to active diagnosis of hypertension” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover M1290?
CMS lists M1290’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 M1290
All M codesM1284Patients 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…M1285Screening, 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…M1291Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement…M1292Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or…M1293Bmi is documented above normal parameters and a follow-up plan is documentedM1294Normal blood pressure reading documented, follow-up not requiredM1295Patients with a diagnosis or past history of total colectomy or colorectal cancerM1296Bmi is documented within normal parameters and no follow-up plan is required