M1210

M1210 — At least two orders for high-risk medications from the same drug class, (table 4), not ordered

Q: What is HCPCS code M1210?

M1210 is a HCPCS Level II code for at least two orders for high-risk medications from the same drug class, (table 4), not ordered. It sits in the Medical Services section.

Q: Does Medicare cover M1210?

The CMS HCPCS file marks M1210 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.

Q: How is M1210 paid under the physician fee schedule?

M1210 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.

HCPCSActiveBETOS Z2

M1210 is a HCPCS Level II code for at least two orders for high-risk medications from the same drug class, (table 4), not ordered. 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 M1210

Long descriptor: At least two orders for high-risk medications from the same drug class, (table 4), not ordered
Short descriptor: >=2 same meds tbl4 not ord
Added: January 1, 2023
BETOS: Z2
Pricing indicator: 00 — Not priced by Part B

Codes adjacent to M1210

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1210 is not quite right, the correct code is very often within a few positions of it.

M1202Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)
M1203Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given
M1204Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4
M1205Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score
M1206Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter
M1207Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety
M1208Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety
M1209At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses
M1211Most recent glycemic status assessment (hba1c or gmi) level > 9.0%
M1212Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period
M1213No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%
M1214Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed
M1215Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)
M1216No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter
M1217Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)
M1218Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)

Questions about M1210

What is HCPCS code M1210?

M1210 is a HCPCS Level II code for at least two orders for high-risk medications from the same drug class, (table 4), not ordered. It sits in the Medical Services section.

Does Medicare cover M1210?

The CMS HCPCS file marks M1210 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 M1210 paid under the physician fee schedule?

M1210 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.