M1367 — Quality care for the treatment of ear, nose, and throat disorders mips value pathway
M1367 is a HCPCS Level II code for quality care for the treatment of ear, nose, and throat disorders mips value pathway. 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 M1367
- Long descriptor
- Quality care for the treatment of ear, nose, and throat disorders mips value pathway
- Short descriptor
- Qual care ent disorder mvp
- 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 M1367
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1367 is not quite right, the correct code is very often within a few positions of it.
- M1359Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained
- M1360Suicidal ideation and/or behavior symptoms based on the c-ssrs
- M1361Suicide risk based on their clinician's evaluation or a clinician-rated tool
- M1362Patients who died during the measurement period
- M1363Patients who did not have a follow-up assessment within 120 days of the index assessment
- M1364Calculated 10-year ascvd risk score of >= 20 percent during the performance period
- M1365Patient encounter during the performance period with hospice and palliative care specialty code 17
- M1366Focusing on women's health mips value pathway
- M1368Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway
- M1369Quality care in mental health and substance use disorders mips value pathway
- M1370Rehabilitative support for musculoskeletal care mips value pathway
- M1371Most recent glycemic status assessment (hba1c or gmi) level < 7.0%
- M1372Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%
- M1373Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%
- M1374An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period
- M1375An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period
Questions about M1367
What is HCPCS code M1367?
M1367 is a HCPCS Level II code for quality care for the treatment of ear, nose, and throat disorders mips value pathway. It sits in the Medical Services section.
Does Medicare cover M1367?
The CMS HCPCS file marks M1367 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 M1367 paid under the physician fee schedule?
M1367 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.