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HCPCS Level II/M-Codes/M1305

M1305 HCPCS Level II Code: Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period

Medicare Coverage & Payment

  • Medicare coverage: Carrier judgment (CMS coverage code C)
  • Payment category: Service not separately priced (pricing indicator 00)
  • BETOS: Z2
  • Effective: January 1, 2024

Source: CMS HCPCS Level II release. Coverage codes indicate how Medicare treats the code, not whether a specific claim will be paid; payer policy and documentation still govern.

Official Registry Overview & Definition

Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period is a HCPCS Level II code (M1305) for a Medicare-covered supply, service, or procedure. Short description: Pneum vax admin 19+.

Nearest Codes in This Family

Official HCPCS Level II classifications closest to M1305 in its code family, with their registry titles.

  • 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
  • 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