M1242 — Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life
M1242 is a HCPCS Level II code for patient did not respond to the question of patient felt this provider and team understood what is important to me in my life. 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
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The CMS record for M1242
- Long descriptor
- Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life
- Short descriptor
- Pt no resp imprt to me
- Added
- January 1, 2024
- 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 M1242
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1242 is not quite right, the correct code is very often within a few positions of it.
- 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
- M1240Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care
- M1241Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem
- M1243Patient provided a response other than "completely true" for the question of patient felt heard and understood by this provider and team
- M1244Patient provided a response other than "completely true" for the question of patient felt this provider and team put my best interests first when making recommendations about my care
- M1245Patient provided a response other than "completely true" for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem
- M1246Patient provided a response other than "completely true" for the question of patient felt this provider and team understood what is important to me in my life
- M1247Patient responded "completely true" for the question of patient felt this provider and team put my best interests first when making recommendations about my care
- M1248Patient responded "completely true" for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem
- M1249Patient responded "completely true" for the question of patient felt this provider and team understood what is important to me in my life
- M1250Patient responded as "completely true" for the question of patient felt heard and understood by this provider and team
Questions about M1242
What is HCPCS code M1242?
M1242 is a HCPCS Level II code for patient did not respond to the question of patient felt this provider and team understood what is important to me in my life. It sits in the Medical Services section.
Does Medicare cover M1242?
The CMS HCPCS file marks M1242 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 M1242 paid under the physician fee schedule?
M1242 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.