M1058

M1058 — Patient was a permanent nursing home resident at any time during the performance period

HCPCSActiveBETOS Z2

M1058 is a HCPCS Level II code for patient was a permanent nursing home resident at any time during the performance 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 M1058

Long descriptor: Patient was a permanent nursing home resident at any time during the performance period
Short descriptor: Pt prm nurs hm res in pp
Added: January 1, 2019
BETOS: Z2
Pricing indicator: 00 — Not priced by Part B

Codes adjacent to M1058

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1058 is not quite right, the correct code is very often within a few positions of it.

M1050Functional status was measured by the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at three months (6 to 20 weeks) postoperativelyterminated
M1051Patient had cancer, acute fracture or infection related to the lumbar spine or patient had neuromuscular, idiopathic or congenital lumbar scoliosis
M1052Leg pain was not measured by the visual analog scale (vas) or numeric pain scale at one year (9 to 15 months) postoperatively
M1053Leg pain was measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperativelyterminated
M1054Patient had only urgent care visits during the performance period
M1055Aspirin or another antiplatelet therapy used
M1056Prescribed anticoagulant medication during the performance period, history of gi bleeding, history of intracranial bleeding, bleeding disorder and specific provider documented reasons: allergy to aspirin or anti-platelets, use of non-steroidal anti-inflammatory agents, drug-drug interaction, uncontrolled hypertension > 180/110 mmhg or gastroesophageal reflux disease
M1057Aspirin or another antiplatelet therapy not used, reason not given
M1059Patient was in hospice or receiving palliative care at any time during the performance period
M1060Patient died prior to the end of the performance period
M1061Patient pregnancyterminated
M1062Patient immunocompromisedterminated
M1063Patients receiving high doses of immunosuppressive therapyterminated
M1064Shingrix vaccine documented as administered or previously receivedterminated
M1065Shingrix vaccine was not administered for reasons documented by clinician (e.g. patient administered vaccine other than shingrix, patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)terminated
M1066Shingrix vaccine not documented as administered, reason not giventerminated

Questions about M1058

What is HCPCS code M1058?

M1058 is a HCPCS Level II code for patient was a permanent nursing home resident at any time during the performance period. It sits in the Medical Services section.

Does Medicare cover M1058?

The CMS HCPCS file marks M1058 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 M1058 paid under the physician fee schedule?

M1058 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.