M1275 — Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period
M1275 is a HCPCS Level II code for patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting 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
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The CMS record for M1275
- Long descriptor
- Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period
- Short descriptor
- Pts hosp exl
- 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 M1275
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1275 is not quite right, the correct code is very often within a few positions of it.
- 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
- M1273Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form
- M1274Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month
- M1276Bmi documented outside normal parameters, no follow-up plan documented, no reason given
- M1277Colorectal cancer screening results documented and reviewed
- M1278Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented
- M1279Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given
- M1280Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy
- M1281Blood pressure reading not documented, reason not given
- M1282Patient screened for tobacco use and identified as a tobacco non-user
- M1283Patient screened for tobacco use and identified as a tobacco user
Questions about M1275
What is HCPCS code M1275?
M1275 is a HCPCS Level II code for patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period. It sits in the Medical Services section.
Does Medicare cover M1275?
The CMS HCPCS file marks M1275 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 M1275 paid under the physician fee schedule?
M1275 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.