M0005 HCPCS code: Value in primary care mips value pathway
M0005 is the HCPCS Level II code for value in primary care mips value pathway. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case.
Code details
| Field | Value |
|---|---|
| Section | M codes — Medical services and quality measures |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | Z2 |
| Added | 2023-01-01 |
| Last action effective | 2024-01-01 |
What changed for M0005
- 2023-01-01: M0005 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code M0005?
M0005 is the HCPCS Level II code for value in primary care mips value pathway. Short descriptor: "Value in primary care mvp".
Does Medicare cover M0005?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related M00 codes
- M0001 — Advancing cancer care mips value pathways
- M0002 — Optimal care for kidney health mips value pathways
- M0003 — Optimal care for patients with episodic neurological conditions mips value pathways
- M0004 — Quality care for patients with neurological conditions mips value pathway
- M0010 — Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services
- M0064 — Brief office visit for the sole purpose of monitoring or changing drug prescriptions used in the treatment of mental psychoneurotic and personality disorders
- M0075 — Cellular therapy
- M0076 — Prolotherapy
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Next steps
- Run a reimbursement report for a device billed under M0005
- Watch M0005 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for M0005
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.