Summary & Overview
HCPCS M1450: Hospice or Palliative Care Service
HCPCS Level II code M1450 denotes that a patient received hospice or palliative care services during the denominator identification or measure assessment period. Nationally, accurate capture of hospice and palliative care via this code is important for quality measurement, care coordination, and aligning provider reporting with performance measures focused on end-of-life and symptom-management care. The code is used across hospice programs, inpatient palliative consult services, and home-based palliative care.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code's clinical meaning and service context, common payer considerations, and typical sites of service. The publication also outlines the types of benchmarks and policy updates relevant to hospice and palliative care reporting, and situates M1450 within clinical workflows and quality measurement frameworks.
This summary provides national context rather than jurisdiction-specific guidance. Data not available in the input for certain fields is noted in the detailed sections.
Billing Code Overview
HCPCS Level II code M1450 indicates that a patient received hospice or palliative care services at any point during the denominator identification period or the measure assessment period. This code documents the presence of hospice or palliative care service in the patient record for quality measurement and reporting purposes.
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Service type: Hospice or palliative care service
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Typical site of service: Hospice settings, inpatient palliative care units, hospital-based palliative care consults, or community/home-based hospice and palliative programs
Clinical & Coding Specifications
Clinical Context
A typical patient is an older adult with advanced, life-limiting illness such as metastatic cancer, end-stage heart failure, advanced chronic obstructive pulmonary disease, or progressive neurodegenerative disease who is enrolled in hospice or receiving palliative care during the measurement period. The patient may be discharged from an inpatient admission to a community hospice program, transitioned from disease-directed therapies to comfort-focused care, or seen in an outpatient palliative clinic where goals-of-care discussions occur. Clinical workflow includes referral to hospice or palliative care from the primary team, completion of hospice eligibility documentation and eligibility certification by the attending physician, initiation of hospice services (nursing, social work, chaplaincy, and bereavement) or palliative care visits, and billing of the hospice/palliative service using billing code M1450. Care coordination and documentation of advance care planning, symptom management, and caregiver education occur during visits and are included in the patient record for numerator/denominator measure determination.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service | When an E/M visit addressing new or unrelated problems is performed the same day as initiation of hospice/palliative procedures or consultations |