M1487 – Patients in hospice in the year before or during the period of evaluation

Long description

Patients in hospice in the year before or during the period of evaluation

Short description

Pt adm to hospice dur eval

Pricing indicator

00 Not separately priced by Part B (bundled, not covered or Part A only)

Medicare coverage

C Carrier judgment – coverage decided by the Medicare contractor

BETOS category

Z2 Undefined codes

Added

January 1, 2026

Last change

January 1, 2026 – No change

Nearby M codes

• M1479 – Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders
• M1480 – Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders
• M1481 – Patients receiving hospice or palliative care or who died during the measurement period
• M1482 – Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period
• M1483 – Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period
• M1484 – Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)
• M1485 – Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period
• M1486 – Patients admitted to a skilled nursing facility (snf) during the period of evaluation
• M1488 – Patients with a diagnosis for dementia in the year before or during the period of evaluation
• M1489 – Patient status documented
• M1490 – Patient status not documented
• M1491 – Receiving esrd mcp dialysis services by the provider during the performance period
• M1492 – Patients who did not report a fall
• M1493 – Documentation of falls not performed due to medical reasons (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)
• M1494 – Patients that reported a fall since the last visit
• M1495 – Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall