M1108 — Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record
M1108 is a HCPCS Level II code for ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record. It belongs to the Medical Services section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusM
Measurement code. Used for reporting purposes only; never paid.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
The CMS record for M1108
- Long descriptor
- Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record
- Short descriptor
- Oc ni pt home prog
- Added
- January 1, 2020
- BETOS
- Z2
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to M1108
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1108 is not quite right, the correct code is very often within a few positions of it.
- M1066Shingrix vaccine not documented as administered, reason not giventerminated
- M1067Hospice services for patient provided any time during the measurement period
- M1068Adults who are not ambulatory
- M1069Patient screened for future fall risk
- M1070Patient not screened for future fall risk, reason not given
- M1071Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomyterminated
- M1106The start of an episode of care documented in the medical record
- M1107Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care
- M1109Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery
- M1110Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
- M1111The start of an episode of care documented in the medical record
- M1112Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care
- M1113Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record
- M1114Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery
- M1115Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
- M1116The start of an episode of care documented in the medical record
Questions about M1108
What is HCPCS code M1108?
M1108 is a HCPCS Level II code for ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record. It sits in the Medical Services section.
Does Medicare cover M1108?
The CMS HCPCS file marks M1108 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is M1108 paid under the physician fee schedule?
M1108 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.