M1261 – Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis
HCPCS Level II code · M codes: Medical Services and Quality Measures
HCPCS codeM1261
- Long description
- Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis
- Short description
- Pts on wtlist bef dialysis
- 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, 2024
- Last change
- January 1, 2024 – No change
Frequently asked questions
What is HCPCS code M1261?
M1261 is a HCPCS Level II code for patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis.
Does Medicare cover M1261?
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
- M1253 – Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)
- M1254 – Patients who were deceased when the hu survey reached them
- M1255 – Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)
- M1256 – Prior history of known cvd
- M1257 – Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified
- M1258 – Cvd risk assessment performed, have a documented calculated risk score
- M1259 – Patient status documented within the first year of initiating dialysis
- M1260 – Patient status not documented within the first year of initiating dialysis
- M1262 – Patients who had a transplant prior to initiation of dialysis
- M1263 – Patients in hospice on their initiation of dialysis date or during the month of evaluation
- M1264 – Patients age 75 or older on their initiation of dialysis date
- M1265 – Cms medical evidence form 2728 for dialysis patients: initial form completed
- M1266 – Patients admitted to a skilled nursing facility (snf)
- M1267 – Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period
- M1268 – Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period
- M1269 – Receiving esrd mcp dialysis services by the provider on the last day of the reporting month
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.