Summary & Overview
HCPCS M1247: Patient Reported - Provider Put Patient's Best Interests First
HCPCS Level II code M1247 denotes a patient-reported response of "completely true" to the statement that the provider and care team put the patient's best interests first when recommending care. As a standardized patient-experience measure, this code reflects trust and perceived provider alignment with patient preferences — factors linked to care adherence, satisfaction, and quality reporting. Nationally, capturing such patient-centered measures supports value-based payment models and quality improvement initiatives across ambulatory settings.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find an overview of the code's clinical and administrative context, typical sites of service, common modifiers (listed separately), and where this measure fits within patient-experience reporting frameworks. The publication summarizes benchmarks and usage patterns where available, notes policy and reporting considerations, and explains implications for quality measurement and documentation. Data not available in the input are identified explicitly where applicable.
Billing Code Overview
HCPCS Level II code M1247 represents a patient-reported experience measure indicating the patient responded "completely true" to the statement that the provider and team put the patient's best interests first when making recommendations about care. This code captures a positive patient experience regarding trust and shared decision-making.
Service type: Patient-reported experience assessment
Typical site of service: Ambulatory clinical settings (office, clinic) and other outpatient care environments where patient experience surveys or assessments are conducted.
Clinical & Coding Specifications
Clinical Context
A patient completes a patient experience survey after an outpatient visit with a primary care provider or specialty clinician. The survey item captured by billing code M1247 documents that the patient answered “completely true” to the statement that the provider and care team “put my best interests first when making recommendations about my care.” Typical workflow: the patient receives the validated patient-reported experience measure (PREM) instrument in-clinic on a tablet, by patient portal, or via mail/email after the visit. Clinic staff or a designated quality coordinator administers or collects responses, scores the item, and the practice generates summary data for quality improvement, value-based contracting, and patient-centered care reporting. Typical sites of service include outpatient clinics, physician offices, and ambulatory care centers. A realistic patient scenario: a 62-year-old patient with multiple chronic conditions attends a scheduled chronic care visit with their primary care physician; following the visit the patient completes the PREM survey and selects “completely true” for the question about the provider putting the patient’s best interests first. The response is recorded and billed using M1247 as part of patient experience reporting and performance measurement activities.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |