M1173 — Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period
M1173 is a HCPCS Level II code for patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period. 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 M1173
- Long descriptor
- Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period
- Short descriptor
- Pt no rec td/tdap 9yrs prior
- Added
- January 1, 2023
- 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 M1173
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1173 is not quite right, the correct code is very often within a few positions of it.
- M1165Patients who use hospice services any time during the measurement period
- M1166Pathology report for tissue specimens produced from wide local excisions or re-excisions
- M1167In hospice or using hospice services during the measurement period
- M1168Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period
- M1169Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)
- M1170Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period
- M1171Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period
- M1172Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)
- M1174Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period
- M1175Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)
- M1176Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period
- M1177Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period
- M1178Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)
- M1179Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period
- M1180Patients on immune checkpoint inhibitor therapy
- M1181Grade 2 or above diarrhea and/or grade 2 or above colitis
Questions about M1173
What is HCPCS code M1173?
M1173 is a HCPCS Level II code for patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period. It sits in the Medical Services section.
Does Medicare cover M1173?
The CMS HCPCS file marks M1173 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 M1173 paid under the physician fee schedule?
M1173 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.