M1257 Cvd risk assess not perf

Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified

Medicare pricing for M1257

Physician Fee Schedule (CY 2026, RVU26D)

Status M: measurement code, reporting only.

Payer policies and prior authorization for M1257

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.