|Description||Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)|
|BETOS Code||M4A - Home visit|
|Action Code||N - No maintenance for this code|
|Type of Service Code||1 - Medical care|
|Pricing Indicator Code||13 - Price established by carriers (e.G., not otherwise classified, individual determination, carrier discretion)|
|Multiple Pricing Indicator Code||A - Not applicable as HCPCS priced under one methodology|
|Coverage Code||C - Carrier judgment|
|Action Effective Date||Jan 01, 2019|
|Code Date Added||Jan 01, 2019|
HCPCS Long Description:
Contains all text of procedure or modifier long descriptions.
As of 2013, this field contains the consumer friendly descriptions for the AMA CPT codes. The AMA owns the copyright on the CPT codes and descriptions; CPT codes and descriptions are not public property and must always be used in compliance with copyright law.
HCPCS Short Description:
Short descriptive text of procedure or modifier code (28 characters or less).
The AMA owns the copyright on the CPT codes and descriptions; CPT codes and descriptions are not public property and must always be used in compliance with copyright law.
HCPCS Pricing Indicator Code:
Code used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.
HCPCS Multiple Pricing Indicator Code:
Code used to identify instances where a procedure could be priced under multiple methodologies.
HCPCS Coverage Code:
A code denoting Medicare coverage status.
HCPCS Action Code:
A code denoting the change made to a procedure or modifier code within the HCPCS system.
Effective date of action to a procedure or modifier code
HCPCS Code Added Date:
The year the HCPCS code was added to the Healthcare common procedure coding system.
HCPCS Type Of Service Code:
The carrier assigned CMS type of service which describes the particular kind(s) of service represented by the procedure code.
HCPCS BETOS Code:
This field is valid beginning with 2003 data. The Berenson-Eggers Type of Service (BETOS) for the procedure code based on generally agreed upon clinically meaningful groupings of procedures and services.