M1231

M1231 — Patient receives hcv antibody test with nonreactive result

HCPCSActiveBETOS Z2

M1231 is a HCPCS Level II code for patient receives hcv antibody test with nonreactive result. 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 M1231

Long descriptor: Patient receives hcv antibody test with nonreactive result
Short descriptor: Pt hcv tst no reactive res
Added: January 1, 2024
BETOS: Z2
Pricing indicator: 00 — Not priced by Part B

Codes adjacent to M1231

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1231 is not quite right, the correct code is very often within a few positions of it.

M1223Glaucoma plan of care documented
M1224Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level
M1225Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level
M1226Iop measurement not documented, reason not otherwise specified
M1227Evidence-based therapy was prescribed
M1228Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test
M1229Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection
M1230Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment initiated within 3 months of the reactive hcv antibody test, reason not given
M1232Patient receives hcv antibody test with reactive result
M1233Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given
M1234Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia
M1235Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period
M1236Baseline mrs > 2
M1237Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)
M1238Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)
M1239Patient did not respond to the question of patient felt heard and understood by this provider and team

Questions about M1231

What is HCPCS code M1231?

M1231 is a HCPCS Level II code for patient receives hcv antibody test with nonreactive result. It sits in the Medical Services section.

Does Medicare cover M1231?

The CMS HCPCS file marks M1231 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 M1231 paid under the physician fee schedule?

M1231 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.