Summary & Overview
HCPCS Level II M1252: Ambulatory Palliative Care Patient Experience Survey Noncompletion
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.
Billing Code Overview
HCPCS Level II code M1252 denotes patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit. The description implies a service focused on ambulatory palliative care patient experience measurement tied to survey return timing.
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Service type: Ambulatory palliative care patient experience survey follow-up
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Typical site of service: Ambulatory palliative care clinic or outpatient palliative care visit
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Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult outpatient receiving an ambulatory palliative care visit focused on symptom management, advance care planning, and psychosocial support. During the visit, the patient is given a standardized patient experience survey (HU survey) containing four core items. The practice’s workflow expects the patient to complete and return the HU survey within 60 days of the visit. A real-world example: a 72-year-old patient with advanced heart failure attends a palliative care clinic for symptom review and medication optimization. The clinician provides the HU survey at discharge; the patient does not complete at least one of the four mandatory items and the clinic documents the incomplete survey and tracks return within 60 days. Typical staff actions include documenting survey distribution, attempting follow-up outreach (phone or mail) to obtain missing items, and submitting the billing code M1252 to indicate the survey was not completed as specified within the 60‑day window.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when documentation supports substantially greater services than typical for the visit due to complexity of palliative care needs. |