HCPCS Level II code M1252 identifies ambulatory palliative care patients who failed to complete at least one of four patient-experience HU survey items and did not return the survey within 60 days of the visit. The code captures a measure of survey noncompletion tied to outpatient palliative care encounters and is relevant to quality assessment, patient experience measurement, and administrative reporting across care settings nationally. Its use affects how providers and payers track patient-reported experience measures and can influence quality tracking and program evaluation efforts.

This publication covers major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical and administrative context for M1252, summaries of payer coverage considerations, common modifiers, and how the code fits into ambulatory palliative care service lines. The report also outlines expected reporting workflows and the implications for patient-experience measurement programs.

The content is designed to inform billing staff, revenue cycle leaders, compliance officers, and clinical program managers about the purpose of M1252, typical sites of service, and where this code sits within outpatient palliative care quality reporting. Data not available in the input will be noted where applicable.