M1363 – Patients who did not have a follow-up assessment within 120 days of the index assessment
HCPCS Level II code · M codes: Medical Services and Quality Measures
HCPCS codeM1363
- Long description
- Patients who did not have a follow-up assessment within 120 days of the index assessment
- Short description
- Pts no f/u 120 dys
- 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 M1363?
M1363 is a HCPCS Level II code for patients who did not have a follow-up assessment within 120 days of the index assessment.
Does Medicare cover M1363?
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
- M1355 – Suicide risk based on their clinician's evaluation or a clinician-rated tool
- M1356 – Patients who died during the measurement period
- M1357 – Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment
- M1358 – Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment
- M1359 – Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained
- M1360 – Suicidal ideation and/or behavior symptoms based on the c-ssrs
- M1361 – Suicide risk based on their clinician's evaluation or a clinician-rated tool
- M1362 – Patients who died during the measurement period
- M1364 – Calculated 10-year ascvd risk score of >= 20 percent during the performance period
- M1365 – Patient encounter during the performance period with hospice and palliative care specialty code 17
- M1366 – Focusing on women's health mips value pathway
- M1367 – Quality care for the treatment of ear, nose, and throat disorders mips value pathway
- M1368 – Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway
- M1369 – Quality care in mental health and substance use disorders mips value pathway
- M1370 – Rehabilitative support for musculoskeletal care mips value pathway
- M1371 – Most recent glycemic status assessment (hba1c or gmi) level < 7.0%
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.