M1264 — Patients age 75 or older on their initiation of dialysis date
M1264 is a HCPCS Level II code for patients age 75 or older on their initiation of dialysis date. It belongs to the Medical Services section. It was terminated on December 31, 2024 and is not valid on new claims.
This code has been terminated
CMS terminated M1264 on December 31, 2024. It stays in the file as history — a claim you are auditing from before that date may legitimately carry it — but it must not appear on a new claim. The adjacent codes below are the usual place to look for its replacement.
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.
The CMS record for M1264
- Long descriptor
- Patients age 75 or older on their initiation of dialysis date
- Short descriptor
- Pts 75+ dialysis dt
- Added
- January 1, 2024
- Terminated
- December 31, 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.
When CMS retired it.
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 M1264
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1264 is not quite right, the correct code is very often within a few positions of it.
- M1256Prior history of known cvd
- M1257Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified
- M1258Cvd risk assessment performed, have a documented calculated risk score
- M1259Patient status documented within the first year of initiating dialysis
- M1260Patient status not documented within the first year of initiating dialysis
- M1261Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis
- M1262Patients who had a transplant prior to initiation of dialysis
- M1263Patients in hospice on their initiation of dialysis date or during the month of evaluation
- M1265Cms medical evidence form 2728 for dialysis patients: initial form completed
- M1266Patients admitted to a skilled nursing facility (snf)
- M1267Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period
- M1268Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period
- M1269Receiving esrd mcp dialysis services by the provider on the last day of the reporting month
- M1270Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period
- M1271Patients with dementia at any time prior to or during the month
- M1272Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period
Questions about M1264
What is HCPCS code M1264?
M1264 is a HCPCS Level II code for patients age 75 or older on their initiation of dialysis date. It sits in the Medical Services section.
Does Medicare cover M1264?
The CMS HCPCS file marks M1264 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.
Is M1264 still valid?
No. M1264 was terminated on December 31, 2024 and should not be used on new claims.