M1204 – Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4
HCPCS Level II code · M codes: Medical Services and Quality Measures
HCPCS codeM1204
- Long description
- Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4
- Short description
- Ixv nrs vrs iqa >=4
- Pricing indicator
00Not separately priced by Part B (bundled, not covered or Part A only)- Medicare coverage
CCarrier judgment – coverage decided by the Medicare contractor- BETOS category
Z2Undefined codes- Added
- January 1, 2023
- Last change
- January 1, 2023 – No change
Frequently asked questions
What is HCPCS code M1204?
M1204 is a HCPCS Level II code for initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4.
Does Medicare cover M1204?
The HCPCS file lists coverage code C: Carrier judgment – coverage decided by the Medicare contractor. Coverage and payment also depend on local coverage determinations and the patient’s plan.
Nearby M codes
- M1196 – Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4
- M1197 – Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score
- M1198 – Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter
- M1199 – Patients receiving rrt
- M1200 – Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period
- M1201 – Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due to ace-i or arb therapy), other medical reasons)
- M1202 – Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)
- M1203 – Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given
- M1205 – Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score
- M1206 – Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter
- M1207 – Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety
- M1208 – Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety
- M1209 – At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses
- M1210 – At least two orders for high-risk medications from the same drug class, (table 4), not ordered
- M1211 – Most recent glycemic status assessment (hba1c or gmi) level > 9.0%
- M1212 – Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.