Summary & Overview

HCPCS Level II M1241: Patient Did Not Respond to 'Seen as a Person' Question

HCPCS Level II code M1241 denotes a patient’s nonresponse to the survey item asking whether the provider and care team “saw me as a person, not just someone with a medical problem.” Capturing this nonresponse is important for patient experience measurement, quality reporting, and survey administration consistency across care settings. Nationally, standardized patient-reported experience measures inform quality improvement, patient-centered care initiatives, and payer contract metrics.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of what this code represents, common clinical contexts and typical sites of service where the code is used, and the implications for patient experience data collection processes. The publication outlines benchmarking considerations and highlights where policy or administrative requirements may affect capture of nonresponse items. Practical information is provided on how this code fits into patient experience measurement workflows and documentation practices.

Data not available in the input for detailed payer-specific reimbursement, associated taxonomies, ICD-10 mappings, or related billing lines.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareM1241HCPCS Level IIpatient experiencepatient-reported outcomeambulatory caresurvey nonresponsequality measurementdocumentation

Billing Code Overview

HCPCS Level II code M1241 indicates that the patient did not respond to the question: patient felt this provider and team saw me as a person, not just someone with a medical problem. This code is used to capture a lack of patient response to that specific patient experience item.

Service type: Patient experience / patient-reported outcome assessment
Typical site of service: Outpatient clinics, ambulatory care settings, primary care practices, or other settings where patient experience surveys or assessments are administered

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient scenario involves an outpatient primary care or behavioral health visit in which a patient is completing a patient-experience or patient-reported outcome survey administered by the provider team. The item represented by billing code M1241 documents that the patient did not respond to the specific question, “Patient felt this provider and team saw me as a person, not just someone with a medical problem.” This can occur when the patient declines to answer, is unable to respond due to cognitive or communication barriers, or the survey was interrupted. The clinical workflow: during check-in or rooming, staff provide the survey electronically or on paper; the clinician reviews responses during the visit; nonresponse for this item is noted in the medical record and reflected for quality reporting and visit-level documentation. Typical sites of service include outpatient primary care clinics, behavioral health clinics, and ambulatory specialty practices. A realistic patient example: a 72-year-old patient with mild cognitive impairment attends a follow-up in primary care, completes most items on the patient experience survey but is unable to answer the question about feeling seen as a person; staff document nonresponse and proceed with the visit and any needed assessments.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required is substantially greater than typical for the service due to extensive documentation or additional time spent addressing survey administration barriers.

Taxonomy Code	Specialty	Notes
`208000000X`	Family Medicine	Primary care clinicians commonly administer patient-experience surveys.
`207Q00000X`	Internal Medicine	Internists frequently collect and document patient-reported experience items.
`103T00000X`	Psychiatric Mental Health	Behavioral health clinicians use experience surveys for patient-centered care measures.
`207R00000X`	Obstetrics & Gynecology	OB/GYN practices may collect patient experience items in ambulatory visits.
`261QM0800X`	Nurse Practitioner	Advanced practice clinicians conduct and document survey administration and nonresponse.

CPT Code	Description	Relationship to This Procedure
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Common E/M code billed for a routine visit during which patient-experience survey items are administered and documented; nonresponse to `M1241` is noted in the visit record.
`99406`	Smoking and tobacco-use cessation counseling visit, intermediate, greater than 3 minutes up to 10 minutes	Example of a counseling service that may be performed in the same visit; documentation may reference survey responses or nonresponse.
`96127`	Brief emotional/behavioral assessment (e.g., depression inventory) with scoring and documentation, per standardized instrument	Behavioral screening often accompanies patient-experience measures; this code is used for brief standardized assessments performed alongside the survey.
`99497`	Advance care planning including explanation and discussion, first 30 minutes	Longer structured conversations documented during the visit; patient experience items may inform or be discussed during advance care planning visits.
`G0439`	Annual alcohol misuse screening, 15 minutes	Preventive screening performed in primary care that may be part of the same visit where patient-experience items are collected.

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