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M1284 Pt 66+ snp or ltc pos > 90d

M Codes

Also known as: senior long-term care, elderly facility resident, SNF >90 days

Patient age 66 and older in a skilled nursing facility or long-term care position for greater than 90 days. Documents older adults with extended institutional care stays.

In Plain Language

nursing home resident elderly; long-term care elder

Clinical Context

Used in quality measures for older adults to identify those with prolonged facility stays requiring ongoing management and care coordination.

RVU Information

CPT M1284 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

GeriatricsInternal MedicineCare Management

Frequently Asked Questions

What is CPT code M1284?

CPT M1284 (Pt 66+ snp or ltc pos > 90d) is a M Codes code. Patient age 66 and older in a skilled nursing facility or long-term care position for greater than 90 days. Documents older adults with extended institutional care stays.

Is M1284 covered by insurance?

M1284 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Used in quality measures for older adults to identify those with prolonged facility stays requiring ongoing management and care coordination.

When is CPT M1284 used?

Used in quality measures for older adults to identify those with prolonged facility stays requiring ongoing management and care coordination.

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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.