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See a sample rate comparisonHCPCS M1207 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety
| Key Fact | Detail |
|---|---|
| Service Type | Other Services |
| Complexity Level | Low |
National average reimbursement for HCPCS M1207 by major payers:
$59.11
$N/A
$49.42
$0.00
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HCPCS M1207
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Payer Contract Negotiation
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See a sample payer proposalHCPCS M1207 vs. Other Other Services Codes
The HCPCS M1207 code is part of the Other Services services . It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS M1207 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| M1206-HCPCS | Low | Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter |
| M1207-HCPCS | Low | Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety |
| M1208-HCPCS | Low | Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS M1207. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the M1207 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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