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HCPCS Level II/M-Codes/M1495

M1495 HCPCS Level II Code: Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall

M1495 is the authoritative medical code for Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall. This classification is used in medical billing and clinical recording to specify the clinical criteria for patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall (HCPCS Level II M1495), ensuring healthcare documentation aligns with current federal coding standards.

Billing Status: Processed within HCPCS Level II standards. CMS regulatory guidelines apply.

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, 2026

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

Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall is a HCPCS Level II code (M1495) for a Medicare-covered supply, service, or procedure. Short description: Fall w/ poc, no fall.

Nearest Codes in This Family

Official HCPCS Level II classifications closest to M1495 in its code family, with their registry titles.

  • M1489 — Patient status documented
  • M1490 — Patient status not documented
  • M1491 — Receiving esrd mcp dialysis services by the provider during the performance period
  • M1492 — Patients who did not report a fall
  • M1493 — Documentation of falls not performed due to medical reasons (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)
  • M1494 — Patients that reported a fall since the last visit
  • M1496 — Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls
  • M1497 — Documentation of falls not performed due to medical reasons (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)
  • M1498 — Diagnostic radiology mips value pathway
  • M1499 — Interventional radiology mips value pathway