Section M: Medical Services
502 HCPCS Level II codes in Section M (2026).
M0001
Advancing cancer care mvp
M0002
Opt care kidney hlth mvp
M0003
Opt care episod neuro mvp
M0004
Qual care neurologic cnd mvp
M0005
Value in primary care mvp
M0010
Eom meos payment
M0064
Visit for drug monitoring
M0075
Cellular therapy
M0076
Prolotherapy
M0100
Intragastric hypothermia
M0201
Pne flu hepb cov home admin
M0220
Tixagev and cilgav inj
M0221
Tixagev and cilgav inj hm
M0222
Bebtelovimab injection
M0223
Bebtelovimab injection home
M0224
Pemivibart infusion
M0235
Intrav inf, mon anti, fir do
M0236
Intrav inf, mon anti, sec do
M0237
Intrav inf, toci, first dose
M0238
Intrav inf, toci, second dos
M0239
Bamlanivimab-xxxx infusion
M0240
Casiri and imdev repeat
M0241
Casiri and imdev repeat hm
M0243
Casirivi and imdevi inj
M0244
Casirivi and imdevi inj hm
M0245
Bamlan and etesev infusion
M0246
Bamlan and etesev infus home
M0247
Sotrovimab infusion
M0248
Sotrovimab inf, home admin
M0249
Adm tocilizu covid-19 1st
M0250
Adm tocilizu covid-19 2nd
M0300
Iv chelationtherapy
M0301
Fabric wrapping of aneurysm
M1000
Pain scr as mod to sevr
M1001
Pln to adrs pain doc
M1002
Pln to adrs pain not doc
M1003
Tb scr 12 mo pri fst bio dz
M1004
Doc med rsn no srn tb
M1005
Tb scr no perf
M1006
Dz not ases, no rsn
M1007
>=50% total pt outpt ra enct
M1008
<50% total pt outpt ra encts
M1009
Dc eoc doc med rec
M1010
Dc eoc doc med rec
M1011
Dc eoc doc med rec
M1012
Dc eoc doc med rec
M1013
Dc eoc doc med rec
M1014
Dc epi care doc medrec
M1015
Dc eoc doc med rec
M1016
Pt dx meop or sur steri
M1017
Pt admt to palitve serv
M1018
Pt dx hst cr pt sk lg cr scr
M1019
Adl pt mj dep ds rs 12 phq<5
M1020
Adl pt mj dep ds no rs 12 mo
M1021
Pt uc in pp
M1022
Pt hospice during perf pd
M1023
Adl pt mj dep ds rs 6 phq<5
M1024
Adl pt mj dep ds no rs 6 mo
M1025
Pt hospice during perf pd
M1026
Pt hospice during perf pd
M1027
Img head (ct or mri) obtnd
M1028
Doc of pt prm hda dx and otr
M1029
Doc sysm rsn img hd
M1030
Pt clin ind img hd
M1031
Pt clin ind img hd
M1032
Adt tkng pharmthry for oud
M1033
Pharmthry for oud afr 6.30
M1034
Adt 180 dys pharmthry oud
M1035
Adt pd out mat pr 180 dys tx
M1036
Adt no 180 dys pharmthry oud
M1037
Pt dx lum sp reg cacr
M1038
Pt dx lum sp reg fract
M1039
Pt dx lum sp reg inf
M1040
Pt dx lum idi or cong scol
M1041
Pt cr ft inf lm or pt id sl
M1042
Ftl st mea sco ot odi 3 mo
M1043
Fs no odi 9-15mo
M1044
Ftl st mea odi 3 mo
M1045
Fs oks 9-15mo >= 37 >= 71
M1046
Fs oks 9-15mo < 37 < 71
M1047
Fs msrd oks pre and post
M1048
Fsm wth scr odi pre and post
M1049
Fs wth scr no odi pre and p
M1050
Fs msrd odi pre and post
M1051
Pt w/cancer scoliosis
M1052
Lg pn not meas w/ vas 1yr po
M1053
Pre and post vas wthn 3 mos
M1054
Pt uc in pp
M1055
Aspirin used
M1056
Presc antico med in pp
M1057
Aspirin not used, no rsn
M1058
Pt prm nurs hm res in pp
M1059
Pt no prm nurs hm res in pp
M1060
Pt died in pp
M1061
Pt preg
M1062
Pt imcomprmd
M1063
Pt rec hg dos imsup thpy
M1064
Shing vac doc adm or pv rec
M1065
Shing vac no adm clinc rsn
M1066
Shing vac no doc no rsn
M1067
Hspc pt prv time meam per
M1068
Pt not ambulatory
M1069
Pt scr ft fall rsk
M1070
Pt not scrn fut fall no rsn
M1071
Pt had add'l sp pcr perf
M1106
Start eoc doc med rec
M1107
Docu dx degen neuro
M1108
Oc ni pt home prog
M1109
Oc ni pt dc
M1110
Oc not p pt selfdc
M1111
Start eoc doc med rec
M1112
Docu dx degen neuro
M1113
Oc ni pt home prog
M1114
Oc ni pt dc
M1115
Oc ni pt selfdc
M1116
Start eoc doc med rec
M1117
Docu dx degen neuro
M1118
Oc ni pt home prog
M1119
Oc ni pt dc
M1120
Oc ni pt selfdc
M1121
Start eoc doc med rec
M1122
Docu dx degen neuro
M1123
Oc ni pt home prog
M1124
Oc ni pt dc 1-2 vis
M1125
Oc ni pt selfdc 1-2 vis
M1126
Start eoc doc med rec
M1127
Docu dx degen neuro
M1128
Oc ni pt home prog
M1129
Oc ni pt dc
M1130
Oc ni pt selfdc
M1131
Docu dx degen neuro
M1132
Oc ni pt home prog
M1133
Oc ni pt dc
M1134
Oc ni pt selfdc
M1135
Start eoc doc med rec
M1136
Start eoc doc med rec
M1137
Docu dx degen neuro
M1138
Oc ni pt 1-2 vis
M1139
Oc ni pt self dc 1-2 vis
M1140
Oc ni pt dc 1-2 vis
M1141
Fs no oks
M1142
Emerge cases
M1143
Ni rehab med chiro
M1144
Oc no ind pt 1-2 vis
M1145
Mfn drug add-on, per dose
M1146
Ongoing care not ind
M1147
Care not poss med rsn
M1148
Pt self dschg
M1149
No neck fs prom incap
M1150
Lvef <=40% or mod/sev l vsf
M1151
Pt w/ hx trnsplt or lvad
M1152
Pt w/ hx trnsplt or lvad
M1153
Pt w/ dx osteo doe
M1154
Hospc serv dur meas pd
M1155
Pt anphx due to pneum
M1156
Pt recd actv chemo any time
M1157
Pt recd bone mar trnsplt
M1158
Pt hx immcomp prior/dur pd
M1159
Hospc serv dur meas pd
M1160
Pt anphx due to mengb bef 13
M1161
Pt anphx due to dtp bef 13
M1162
Pt enceph due to dtp bef 13
M1163
Pt anphx due to hpv bef 13
M1164
Pt w/ dementia any time
M1165
Pt use hspc dur meas pd
M1166
Path rpt tis spec wle/reexc
M1167
Hspc dur meas pd
M1168
Pt recd flu vax 7/1-6/30
M1169
Doc med rsn no flu vax
M1170
Pt w/o flu vax 7/1-6/30
M1171
Pt recd 1 td/tdap 9yrs prior
M1172
Doc med rsn no td/tdap
M1173
Pt no rec td/tdap 9yrs prior
M1174
Pt w/ 2 hzv 10/2017 - mp
M1175
Doc med rsn no hzv
M1176
No 2 hzv 10/2017-meas pd
M1177
Pt recd pcv on/aft 19
M1178
Doc med rsn no pcv
M1179
No pcv recd
M1180
Pt imm ckpt inhib therapy
M1181
Gr 2 or> dia or gr2 or> col
M1182
Not elg pre ex ibd/uc/crohn
M1183
Doc imm ckpt inhib hld
M1184
Doc med rsn no cst/ist rx
M1185
Imm ckpt inhib not hld no rx
M1186
Pt w/ rx for hspc/plltv care
M1187
Pt w/ esrd
M1188
Pt w/ ckd stg 5
M1189
Doc khe pef w/efgr/uacr
M1190
Doc khe not pef w/efgr/uacr
M1191
Hspc svc any time in meas pd
M1192
Pt w/ dx sq cell ca of esoph
M1193
Rpts w/ imp/con mmr/msi
M1194
Med rsn no imp/con mmr/msi
M1195
Rpt wo imp/con mmr/msi
M1196
Ixv nrs vrs iqa >=4
M1197
Isa reduced >=3 fr ixv
M1198
Isa not red 3pts /no assess
M1199
Pt rec'g rrt
M1200
Ace-i/arb rx
M1201
Med rsn no ace-i/arb rx
M1202
Pt rsn no ace-i/arb rx
M1203
No rsn ace-i/arb rx
M1204
Ixv nrs vrs iqa >=4
M1205
Isa reduced >=3
M1206
Isa not red 3pts/no assess
M1207
Pt scrn sdoh
M1208
Pt no scrn sdoh
M1209
>=2 same hi-rsk med w/o diag
M1210
>=2 same meds tbl4 not ord
M1211
Gsa level>9.0%
M1212
Missing gsa not perf
M1213
No hx spiro prs spiro>=70%
M1214
Spiro results wth obs doc
M1215
Med rsn for no doc spiro
M1216
No spiro doc no res doc
M1217
Sys rsn no doc spiro
M1218
Pt copd symptoms
M1219
Anphx due to vax
M1220
Dre wth interp rtnopthy
M1221
Dre w/o rtnopthy
M1222
Glaucoma pln of care not doc
M1223
Glaucoma plan of care doc
M1224
Iop dec <20% from base
M1225
Iop dec>=20% from base
M1226
Iop not doc
M1227
Eb therapy prescribed
M1228
Pt + hcv aby +vir w/ rx 3 mo
M1229
Pt w/ +hcv +vir ref win 1 mo
M1230
Pt hcv rctv aby no f/u tst
M1231
Pt hcv tst no reactive res
M1232
Pt hcv tst reactive result
M1233
Pt no hcv aby or result
M1234
Pt hcv rctv aby f/u neg
M1235
Doc pt hcv aby rna tst
M1236
Baseline mrs > 2
M1237
Pt rsn no scrn
M1238
Doc 2nd recom hzv 2-6 mo int
M1239
Pt no resp heard
M1240
Pt no resp best int
M1241
Pt no resp seen as person
M1242
Pt no resp imprt to me
M1243
Pt othr thn true heard
M1244
Pt othr thn true best int
M1245
Pt othr thn true person
M1246
Pt othr thn true imprt to me
M1247
Pt resp true best int
M1248
Pt resp true seen as person
M1249
Pt resp true imprt to me
M1250
Pt resp true heard
M1251
Pts proxy cmplt hu surv
M1252
Pts no cmplt hu survey
M1253
Pts hu surv no amb plltv
M1254
Pts deceased prior hu surv
M1255
Pts w/ othr rsn vst,+prg tst
M1256
Prior history of known cvd
M1257
Cvd risk assess not perf
M1258
Cvd risk assess perf
M1259
Pt stat doc <= 1 yr dialysis
M1260
Pt not doc <= 1 yr dialysis
M1261
Pts on wtlist bef dialysis
M1262
Pts transplt bef dialysis
M1263
Pts hosp dialysis dt
M1264
Pts 75+ dialysis dt
M1265
Cms 2728 completed
M1266
Pts admit snf
M1267
Pt no act kid transplt wtlst
M1268
Pt ac stat kid trnsplt wtlst
M1269
Rec'd esrd mcp lst day of mo
M1270
Pts no kid transplt wtlst
M1271
Pts dem any time/dur mo
M1272
Pts kid transplt wtlst
M1273
Pts snf 1 yr dialysis
M1274
Pts snf exl mo
M1275
Pts hosp exl
M1276
Calc bmi out nrm param nof/u
M1277
Colorectal ca screen doc rev
M1278
Pre-htn or htn doc, f/u indc
M1279
Pre-htn/htn, no f/u, not gvn
M1280
Bilat mast/hx bi /unilat mas
M1281
Bp scrn no perf at interval
M1282
Pt scrn tbco id as non user
M1283
Pt scrn tbco and id as user
M1284
Pt 66+ snp or ltc pos > 90d
M1285
Scrn mam perf rslts not doc
M1286
Bmi doc onl fup not cmpltd
M1287
Calc bmi blw low param f/u
M1288
Doc rsn no hbp scrn or f/u
M1289
No pt tbco cess interv rng
M1290
Pt not eli d/t act dig htn
M1291
Pt 66+ frailty and med dem
M1292
Pt 66+ frail inpt adv ill
M1293
Calc bmi abv up param f/u
M1294
Bp scrn perf rec interval
M1295
Pt hx tot col or colon ca
M1296
Calc bmi norm parameters
M1297
Bmi not doc medrsn ptref
M1298
Doc pt preg dur msrmt pd
M1299
Flu immunize order/admin
M1300
Flu imm no admin doc rea
M1301
Pt recv tbco cess interv
M1302
Scrn mam perf rslts doc
M1303
Hospc serv dur meas pd
M1304
No pneum vax admin 19+
M1305
Pneum vax admin 19+
M1306
Pt anphx due to pneum
M1307
Doc pt pal or hospice
M1308
Flu immunize no admin
M1309
Pall serv during meas
M1310
Pt scr tob & cess int
M1311
Aphlx to vax bef enc
M1312
No pt tbco scrn rng
M1313
No tob scr/cess int
M1314
Bmi not calculated
M1315
Crc no doc no rsn
M1316
Tobacco non-user
M1317
Pts counsl cpt opt out
M1318
Pts no csp doc contact
M1319
Pts csp doc contact
M1320
Pts scrn + hrsn
M1321
Pts no 7wk inj,no iop,iop>25
M1322
Pts 7wk inj, scrn iop =<25
M1323
Pts 7wk inj, scrn iop >25
M1324
Pts intravitreal/pci
M1325
Doc med rsn not seen
M1326
Pts dx hypotony
M1327
Pts no eval ini xm no 8 wks
M1328
Pts dx acute vitreous hem
M1329
Pts act pvd 2 wks 8 wks
M1330
Doc pts rsn no f/u xm
M1331
Pts eval ini xm 8 wks
M1332
Pts no eval ini xm no 2 wks
M1333
Acute vitreous hemorrhage
M1334
Pts act pvd 2 wks 2 wks
M1335
Doc pts rsn no f/u xm
M1336
Pts eval ini xm 2 wks
M1337
Acute pvd
M1338
Pt f/u 30-180 dys no + imprv
M1339
Pts f/u 30-180 dys + improv
M1340
Indx whodas 2.0 or sds
M1341
Pt no f/u 30-180 dys
M1342
Pts died perf per
M1343
Pt pam lvl 4 base or srt lin
M1344
No bsln/2nd pam score 4-12mo
M1345
Pt bsln pam, 2nd scr 4-12 mo
M1346
No pam inc 6 pts 4-12 mo
M1347
Pt pam incr 3 pt 4-12 mo
M1348
Pam incr 6 pt 4-12 mo
M1349
No pam inc 3 pts 4-12 mo
M1350
Pt w/ suic saf pln init rev
M1351
Pt cmplt suicd saf pln 120dy
M1352
Suicd c-ssrs assessment, equ
M1353
Pts no cmplt suicd saf pln
M1354
Pt no suicd saf pln 120dy
M1355
Suicd based cln eval
M1356
Pt died dur meas pd
M1357
Pt w/red suic idea 120 days
M1358
Pts no <suicd idea 120 dys
M1359
Indx suicd idea, no 0 scr
M1360
Suicd c-ssrs assessment
M1361
Suicd based cln eval
M1362
Pt died dur meas pd
M1363
Pts no f/u 120 dys
M1364
Ascvd risk >=20pct
M1365
Hosp+pall care spec code 17
M1366
Focus on women's health mvp
M1367
Qual care ent disorder mvp
M1368
Prev trt inf d/o hiv/hep mvp
M1369
Qualcare mental hlth/sud mvp
M1370
Rehab support msk care mvp
M1371
Mst rec gsa<7
M1372
Mst rec gsa >=7 and<8
M1373
Mst rec gsa >=8 and <=9
M1374
Ra dx enc 90 days dur per pd
M1375
Ra dx enc 90 days dur per pd
M1376
Ra dx enc 90 days dur per pd
M1377
Fu colscop 10 yr doc w/ disc
M1378
Med rsn no 10 yr fu colscope
M1379
10 yr fu no rec rsn not giv
M1380
2 rx in perf pd any com meds
M1381
Pt sec strk wthin 5 days
M1382
Enc dur perf pd pos 11
M1383
Acute pvd
M1384
Pt died dur perf pd
M1385
Pt rsn not seen 2nd pam
M1386
Exc sx melmn or mlnm is
M1387
Pt died dur perf pd
M1388
Pt doc exm rec melmn
M1390
Pt no doc exm for rec
M1391
All pt dx w/ rec mlnm
M1392
Pt rsn no exm or lst to fu
M1393
Pr no dx rec mlnm
M1394
Stg i-iii br ca
M1395
Init chemo w/def dur ec grp
M1396
Pt ther clin trial
M1397
Pt w/ recur/prog
M1398
Bslne and fu promis doc
M1399
Pt lve prac
M1400
Pt died dur perf pd
M1401
Stg i-iii br ca
M1402
Init chemo w/def dur ec grp
M1403
Bslne and fu promis doc
M1404
Pt ther clin trial
M1405
Pt w/ recur/prog
M1406
Pt lve prac
M1407
Pt died dur perf pd
M1408
Gmln brca bef dx ca
M1409
Recd gmln brca1/brca2 couns
M1410
No gmln brca1/brca2 couns
M1411
1st ln ici no chemo
M1412
Met nsclc w/ egfr alk oth ab
M1413
Pos pdl1 bef init ici tx
M1414
Med rsn no pdl1 bef 1st ther
M1415
No pos pdl1 bef ici ther
M1416
Pt rec hosp
M1417
Pt up to date cov
M1418
Med rsn not up to date cov
M1419
Pt not up to date cov
M1420
Complete ophthalmologic mvp
M1421
Dermatological care mvp
M1422
Gastroenterology care mvp
M1423
Opt care urologic cnd mvp
M1424
Pulmonology care mvp
M1425
Surgical care mvp
M1426
Telehealth enc
M1427
Doc med rsn bone scn
M1428
Bilateral absence of eyes
M1429
Retinopathy in od, os, ou
M1430
Ret exm ou no retinopthy doc
M1431
Telehealth enc
M1432
Telehealth enc
M1433
Oral chemo wthn 30 days enc
M1434
Orl chemo wthn 30 d post enc
M1435
Oral chemo in perf pd
M1436
Telehealth enc
M1437
Telehealth enc
M1438
Lst knwn well <=210 min
M1439
Sig ocu cond imp surg out
M1440
Telehealth enc
M1441
Init dx slp apn = 1st enc
M1442
Telehealth enc
M1443
Telehealth enc
M1444
Del < 39 weeks gest
M1445
Pp care visit by 12 weeks
M1446
Pt died bef end meas pd
M1447
Pt dx bd bef end meas pd
M1448
Pt dx pd bef end meas pd
M1449
Pt dx scz/pys bef end msr pd
M1450
Pt hos/pal care dur id/pf pd
M1451
Pt dx ppd dur id/pf pd
M1452
Pt dx dementia ever
M1453
Preop vis acu > 20/40
M1454
New cied
M1455
Rep/rev cied
M1456
Pt had htx
M1457
Dx asth dur crnt/prv perf pd
M1458
Pt died bef end meas pd
M1459
Pt hosp/pal care dur perf pd
M1460
Dx copd, cf, or arf
M1461
Pt dx chron hepc
M1462
Pt clin ind hd image
M1463
2 f/u wthn 180 day rx atmp
M1464
No record of f/u by 180 days
M1465
F/u > 180 days after rx
M1466
Pt disc/lam proc same day
M1467
Pt dx lynch syn
M1468
Hep b vaccine received
M1469
Hx of hep b, or pos bld test
M1470
Hep b vac not rec'd med rsn
M1471
Ffs hep b not covered
M1472
Hep b vaccine not received
M1473
Pt func cap not allow impr
M1474
Pt dx dementia
M1475
Pt dx huntington
M1476
Pt dx cog imp or ad
M1477
Dx delirium
M1478
Psychoactive sub abuse
M1479
Pt func cap not allow impr
M1480
Pt func cap not allow impr
M1481
Pt in hosp/pal care who died
M1482
Pos quan hep c or qual rna
M1483
Neg quan hep c or qual rna
M1484
No rpt hcv rna perf med rsn
M1485
Neg viro resp hep c/qual rna
M1486
Pt admitted to snf dur eval
M1487
Pt adm to hospice dur eval
M1488
Dx dementia in msr timeframe
M1489
Pt status doc
M1490
Pt status not doc
M1491
Rec'd esrd mcp dur perf pd
M1492
No reported fall
M1493
No fall doc med rsn
M1494
Fall rep since last visit
M1495
Fall w/ poc, no fall
M1496
No doc of fall or poc
M1497
No doc fall med rsn
M1498
Diagnostic radiology mvp
M1499
Interventional radiology mvp
M1500
Neuropsychology mvp
M1501
Pathology mvp
M1502
Podiatry mvp
M1503
Vascular surgery mvp