HCPCS Service Codes - Medical care

HCPCS Service Code 1 for Medical care.

HCPCS Type of Service (TOS) code is an indicator that the contractor places on Form CMS-1500. The indicator is mainly used for data purposes, however in some instances, it affects payment. All HCPCS codes have a corresponding TOS indicator.

Below are all available HCPCS TOS codes. Find an HCPCS code based on the type of service.

HCPCS Codes for Medical care

  • M1296

    Bmi is documented within normal parameters and no follow-up plan is required

  • M1297

    Bmi not documented due to medical reason or patient refusal of height or weight measurement

  • M1298

    Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter

  • M1299

    Influenza immunization administered or previously received

  • 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)

  • M1301

    Patient 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)

  • M1302

    Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed

  • M1303

    Hospice services provided to patient any time during the measurement period

  • M1304

    Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period

  • M1305

    Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period

  • M1306

    Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period

  • M1307

    Documentation stating the patient has received or is currently receiving palliative or hospice care

  • M1308

    Influenza immunization was not administered, reason not given

  • M1309

    Palliative care services provided to patient any time during the measurement period

  • M1310

    Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user

  • M1311

    Anaphylaxis due to the vaccine on or before the date of the encounter

  • M1312

    Patient not screened for tobacco use

  • M1313

    Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period

  • M1314

    Bmi not documented and no reason is given

  • M1315

    Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified

  • M1316

    Current tobacco non-user

  • M1317

    Patients who are counseled on connection with a csp and explicitly opt out

  • M1318

    Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp

  • M1319

    Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening

  • M1320

    Patients who screened positive for at least 1 of the 5 hrsns

  • M1321

    Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg

  • M1322

    Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye

  • M1323

    Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented

  • M1324

    Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)

  • M1325

    Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within seven (7) weeks of treatment)

  • M1326

    Patients with a diagnosis of hypotony

  • M1327

    Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks

  • M1328

    Patients with a diagnosis of acute vitreous hemorrhage

  • M1329

    Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter

  • M1330

    Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)

  • M1331

    Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam

  • M1332

    Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks

  • M1333

    Acute vitreous hemorrhage

  • M1334

    Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter

  • M1335

    Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)

  • M1336

    Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks

  • M1337

    Acute pvd

  • M1338

    Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period

  • M1339

    Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period

  • M1340

    Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period

  • M1341

    Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period

  • M1342

    Patients who died during the performance period

  • M1343

    Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses

  • M1344

    Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score

  • M1345

    Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score