M1423 – Optimal care for patients with urologic conditions mips value pathway
HCPCS Level II code · M codes: Medical Services and Quality Measures
HCPCS codeM1423
- Long description
- Optimal care for patients with urologic conditions mips value pathway
- Short description
- Opt care urologic cnd mvp
- 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, 2025
- Last change
- January 1, 2025 – No change
Frequently asked questions
What is HCPCS code M1423?
M1423 is a HCPCS Level II code for optimal care for patients with urologic conditions mips value pathway.
Does Medicare cover M1423?
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
- M1415 – Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy
- M1416 – Patient received hospice services any time during the performance period
- M1417 – Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination
- M1418 – Patients 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 clinician
- M1419 – Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination
- M1420 – Complete ophthalmologic care mips value pathway
- M1421 – Dermatological care mips value pathway
- M1422 – Gastroenterology care mips value pathway
- M1424 – Pulmonology care mips value pathway
- M1425 – Surgical care mips value pathway
- M1426 – Encounters conducted via telehealth
- M1427 – Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)
- M1428 – Patients who have bilateral absence of eyes any time during the patient's history through the end of the measurement period
- M1429 – Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented
- M1430 – Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)
- M1431 – Encounters conducted via telehealth
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.