M1479 — Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders
M1479 is a HCPCS Level II code for patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders. 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 M1479
- Long descriptor
- Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders
- Short descriptor
- Pt func cap not allow impr
- Added
- January 1, 2026
- 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 M1479
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1479 is not quite right, the correct code is very often within a few positions of it.
- M1471Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules
- M1472Patient did not receive recommended doses of hepatitis b vaccination based on age
- M1473Patient situations, at any point during the denominator identification period, where the patient's functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders
- M1474Patients with diagnosis of dementia
- M1475Patients with diagnosis of huntington's disease
- M1476Patients with diagnosis of cognitive impairment or alzheimer's disease
- M1477Diagnosis of delirium
- M1478Psychoactive substance abuse
- M1480Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders
- M1481Patients receiving hospice or palliative care or who died during the measurement period
- M1482Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period
- M1483Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period
- M1484Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)
- M1485Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period
- M1486Patients admitted to a skilled nursing facility (snf) during the period of evaluation
- M1487Patients in hospice in the year before or during the period of evaluation
Questions about M1479
What is HCPCS code M1479?
M1479 is a HCPCS Level II code for patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders. It sits in the Medical Services section.
Does Medicare cover M1479?
The CMS HCPCS file marks M1479 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 M1479 paid under the physician fee schedule?
M1479 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.