M1274 Pts snf exl mo
Also known as: SNF prior stay, nursing home history, facility residence
Patient in skilled nursing facility (SNF) excluding the current measurement month. Documents patients transferred to or already residing in long-term care facilities prior to measurement period.
In Plain Language
nursing home patient; long-term care resident
Clinical Context
Used to identify patients with SNF residency history for stratification in ESRD quality measures and to adjust comparisons for facility-level care quality.
RVU Information
CPT M1274 does not have a physician work RVU assigned by CMS. Reimbursement for this code is determined by payer-specific fee schedules.
Billing & Documentation
M-codes cover quality measures and performance reporting. They are used in value-based care programs to track whether specific clinical actions were taken. Documentation must support that the measured action was performed or a valid exclusion applies.
Specialties
Frequently Asked Questions
What is CPT code M1274?
CPT M1274 (Pts snf exl mo) is a M Codes code. Patient in skilled nursing facility (SNF) excluding the current measurement month. Documents patients transferred to or already residing in long-term care facilities prior to measurement period.
Is M1274 covered by insurance?
M1274 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Used to identify patients with SNF residency history for stratification in ESRD quality measures and to adjust comparisons for facility-level care quality.
When is CPT M1274 used?
Used to identify patients with SNF residency history for stratification in ESRD quality measures and to adjust comparisons for facility-level care quality.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.