HCPCS Level II · Medical services and quality measures
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
✓ Active
Source: CMS HCPCS quarterly update, October 2026. Page updated September 29, 2026.
About M1473
M1473 is an HCPCS Level II code in the M series (medical services and quality measures), describing patient 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.
It was added to HCPCS effective 01/01/2026.
Its Medicare coverage code is "C", meaning coverage is left to the Medicare contractor's judgment.
Details
- Short description
- Pt func cap not allow impr
- Date added
- 01/01/2026
- Action effective
- 01/01/2026
- BETOS
- Z2
Related M14xx codes
- M1400Patients who died during the follow-up period
- M1401Stages i-iii breast cancer
- M1402Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group
- M1403Patients with baseline and follow-up promis surveys documented in the medical record
- M1404Patients on a therapeutic clinical trial
- M1405Patients with recurrence/disease progression
- M1406Patients who leave the practice during the follow-up period
- M1407Patients who died during the follow-up period
- M1408Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer
- M1409Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis
- M1410Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis
- M1411Currently on first-line immune checkpoint inhibitors without chemotherapy
Common questions about M1473
Is HCPCS M1473 still valid?
- Yes. M1473 is active in the CMS October 2026 HCPCS file.
Does Medicare cover M1473?
- Its coverage code is "C": coverage is left to the Medicare contractor's judgment. Check the local coverage determination for your region.