Summary & Overview
HCPCS M1445: Postpartum Care Visit, Up to 12 Weeks
HCPCS Level II code M1445 denotes a postpartum care visit provided before or at 12 weeks after childbirth. This code captures a discrete clinical encounter centered on postpartum recovery, counseling, assessment of physical and mental health, and coordination of ongoing care. Nationally, clear coding for postpartum visits supports maternal health monitoring, quality measurement, and appropriate payment for early postpartum services — a period associated with critical maternal morbidity and care transitions.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of how M1445 is used in clinical practice, typical sites of service, and what the code signifies for claims processing and maternal care documentation. The publication also summarizes benchmark considerations, common billing scenarios, and relevant policy updates shaping postpartum care coverage nationally. Where specific payer policies or fee schedules are not provided in the source, the report indicates that data is not available in the input. The content is intended for a national audience of clinicians, billing professionals, and policy analysts seeking concise guidance on the clinical and administrative meaning of HCPCS Level II code M1445.
Billing Code Overview
HCPCS Level II code M1445 represents a postpartum care visit before or at 12 weeks of giving birth. This service covers a clinical visit focused on the medical, emotional, and social needs of a birthing parent during the early postpartum period.
Service type: Postpartum follow-up visit
Typical site of service: Outpatient clinic or office visit, including obstetrics/gynecology practices, family medicine clinics, and community health centers.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 28-year-old patient presents for a postpartum care visit within six weeks of a term vaginal delivery. The patient completed hospital discharge on postoperative day 2 and has since been recovering at home. The clinic workflow begins with nursing intake to review vital signs, bleeding, lochia, wound/incision checks if cesarean, breastfeeding status, mood screening (e.g., postpartum depression screening), contraception counseling, medication reconciliation, and review of newborn care concerns. The provider (obstetrician-gynecologist, family medicine physician, or certified nurse-midwife) performs a focused history and physical exam addressing uterine involution, perineal healing or cesarean incision inspection, blood pressure check, assessment for signs of infection, thromboembolic symptoms, and postpartum mood disorders. Labs or further testing (e.g., urine analysis, CBC) are ordered if indicated. Documentation captures timing relative to delivery (before or at 12 weeks postpartum), diagnoses tied to postpartum care, counseling rendered (contraception, lactation support), and any procedures performed. Typical follow-up actions include scheduling routine well-woman visits, referring to behavioral health if screening positive for depression, or arranging specialty care for complications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of a procedure or other service | Use when an unrelated, significant E/M visit occurs on the same day as a procedure performed during the postpartum visit |