M1294

M1294 — Normal blood pressure reading documented, follow-up not required

HCPCSActiveBETOS Z2

M1294 is a HCPCS Level II code for normal blood pressure reading documented, follow-up not required. 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 M1294

Long descriptor: Normal blood pressure reading documented, follow-up not required
Short descriptor: Bp scrn perf rec interval
Added: January 1, 2024
BETOS: Z2
Pricing indicator: 00 — Not priced by Part B

Codes adjacent to M1294

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1294 is not quite right, the correct code is very often within a few positions of it.

M1286Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason
M1287Bmi is documented below normal parameters and a follow-up plan is documented
M1288Documented reason for not screening or recommending a follow-up for high blood pressure
M1289Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)
M1290Patient not eligible due to active diagnosis of hypertension
M1291Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period
M1292Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period
M1293Bmi is documented above normal parameters and a follow-up plan is documented
M1295Patients with a diagnosis or past history of total colectomy or colorectal cancer
M1296Bmi is documented within normal parameters and no follow-up plan is required
M1297Bmi not documented due to medical reason or patient refusal of height or weight measurement
M1298Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter
M1299Influenza immunization administered or previously received
M1300Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)
M1301Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)
M1302Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed

Questions about M1294

What is HCPCS code M1294?

M1294 is a HCPCS Level II code for normal blood pressure reading documented, follow-up not required. It sits in the Medical Services section.

Does Medicare cover M1294?

The CMS HCPCS file marks M1294 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 M1294 paid under the physician fee schedule?

M1294 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.