M1300 — Influenza 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)
M1300 is a HCPCS Level II code for influenza 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). 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 M1300
- Long descriptor
- Influenza 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)
- Short descriptor
- Flu imm no admin doc rea
- 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 M1300
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1300 is not quite right, the correct code is very often within a few positions of it.
- 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
- M1294Normal blood pressure reading documented, follow-up not required
- 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
- 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
- M1303Hospice services provided to patient any time during the measurement period
- M1304Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period
- M1305Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period
- M1306Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period
- M1307Documentation stating the patient has received or is currently receiving palliative or hospice care
- M1308Influenza immunization was not administered, reason not given
Questions about M1300
What is HCPCS code M1300?
M1300 is a HCPCS Level II code for influenza 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). It sits in the Medical Services section.
Does Medicare cover M1300?
The CMS HCPCS file marks M1300 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 M1300 paid under the physician fee schedule?
M1300 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.