M1331 HCPCS Level II code: Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam
M1331 is the HCPCS code for “Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
M1331Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam
Short description: Pts eval ini xm 8 wks
HCPCS · United States
Medicare details
The indicators CMS publishes with M1331 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 M1331 sits
- 1M codesMedical services and quality measures
- 2Active code M1331Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam
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 M1331 mean?
M1331 is the HCPCS code for “Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover M1331?
CMS lists M1331’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 M1331
All M codesM1325Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or…M1326Patients with a diagnosis of hypotonyM1327Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeksM1328Patients with a diagnosis of acute vitreous hemorrhageM1329Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounterM1330Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)M1332Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeksM1333Acute vitreous hemorrhageM1334Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounterM1335Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)M1336Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeksM1337Acute pvd