Summary & Overview
HCPCS M1502: Podiatry MIPS Value Pathway
HCPCS Level II code M1502 identifies the podiatry MIPS value pathway—a designation for podiatry-focused performance measures and reporting under value-based programs. Nationally, this code matters because it ties podiatric clinical practice to quality measurement infrastructure that influences provider performance reporting and potential payment adjustments across public and private payers. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn what the code represents, how it maps to podiatry practice and ambulatory sites of care, and which payers recognize or align with MIPS-related reporting constructs. The publication provides benchmark context, outlines relevant policy and program updates affecting MIPS value pathways, and offers clinical context for how podiatry practices engage with quality measurement. It also summarizes common operational implications for billing, claims submission, and coordination with payer reporting requirements. Data not available in the input is noted where specific payer coverage details or modifiers are not provided.
Billing Code Overview
HCPCS Level II code M1502 represents the Podiatry MIPS value pathway. This code denotes services tied to the podiatry-focused Merit-based Incentive Payment System (MIPS) value pathway, centered on performance measurement and reporting in podiatric practice.
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Service Type: Performance measurement and quality reporting activities related to podiatry practice
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Typical Site of Service: Ambulatory clinic or podiatry practice setting
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Clinical & Coding Specifications
Clinical Context
A middle-aged patient with chronic forefoot pain related to diabetic peripheral neuropathy and a history of recurrent plantar ulceration presents to a podiatry clinic for enrollment in a MIPS Value Pathway focused on podiatric quality metrics. The clinical workflow begins with a comprehensive podiatric evaluation including medical history review, vascular and neurologic foot exam, wound assessment if present, and review of glycemic control. The podiatrist documents baseline measures aligned with MIPS benchmarks (e.g., foot ulcer outcomes, preventive foot exam frequency, patient education). Diagnostic testing such as foot radiographs or vascular studies is ordered as indicated. A personalized care plan is created that may include debridement, offloading, durable medical equipment recommendations, referral to diabetes education or vascular surgery, and scheduled follow-up visits to capture quality metrics and clinical outcomes required for the value pathway reporting. Data abstraction and submission occur through the practice’s certified registry or the Medicare Quality Payment Program portal to meet MIPS Value Pathway reporting requirements.
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 | Use when an E/M visit is performed on the same day as a podiatric procedure and the E/M is distinct from the procedure work |