M1423 HCPCS Level II code: Optimal care for patients with urologic conditions mips value pathway
M1423 is the HCPCS code for “Optimal care for patients with urologic conditions mips value pathway” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
M1423Optimal care for patients with urologic conditions mips value pathway
Short description: Opt care urologic cnd mvp
HCPCS · United States
Medicare details
The indicators CMS publishes with M1423 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, 2025
Where M1423 sits
- 1M codesMedical services and quality measures
- 2Active code M1423Optimal care for patients with urologic conditions mips value pathway
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 M1423 mean?
M1423 is the HCPCS code for “Optimal care for patients with urologic conditions mips value pathway” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover M1423?
CMS lists M1423’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 M1423
All M codesM1417Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccinationM1418Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by…M1419Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccinationM1420Complete ophthalmologic care mips value pathwayM1421Dermatological care mips value pathwayM1422Gastroenterology care mips value pathwayM1424Pulmonology care mips value pathwayM1425Surgical care mips value pathwayM1426Encounters conducted via telehealthM1427Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)M1428Patients who have bilateral absence of eyes any time during the patient's history through the end of the measurement periodM1429Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented