M1494 — Patients that reported a fall since the last visit
M1494 is a HCPCS Level II code for patients that reported a fall since the last visit. 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 M1494
- Long descriptor
- Patients that reported a fall since the last visit
- Short descriptor
- Fall rep since last visit
- Added
- January 1, 2026
- 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 M1494
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1494 is not quite right, the correct code is very often within a few positions of it.
- M1486Patients admitted to a skilled nursing facility (snf) during the period of evaluation
- M1487Patients in hospice in the year before or during the period of evaluation
- M1488Patients with a diagnosis for dementia in the year before or during the period of evaluation
- M1489Patient status documented
- M1490Patient status not documented
- M1491Receiving esrd mcp dialysis services by the provider during the performance period
- M1492Patients who did not report a fall
- M1493Documentation 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)
- M1495Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall
- M1496Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls
- M1497Documentation 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)
- M1498Diagnostic radiology mips value pathway
- M1499Interventional radiology mips value pathway
- M1500Neuropsychology mips value pathway
- M1501Pathology mips value pathway
- M1502Podiatry mips value pathway
Questions about M1494
What is HCPCS code M1494?
M1494 is a HCPCS Level II code for patients that reported a fall since the last visit. It sits in the Medical Services section.
Does Medicare cover M1494?
The CMS HCPCS file marks M1494 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 M1494 paid under the physician fee schedule?
M1494 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.