CPT code 1111F: Medication reconciliation, quality measure2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 1111F in California.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 1111F covers

1111F reports that a patient's discharge medications were reconciled with the current medication list. It is a CPT Category II performance-measure code used to track completion of this medication-reconciliation step after discharge, rather than a medication, prescription, or medication-management service. The clinician or practice reports the measure when reconciliation is completed as part of post-discharge care.

Medicare classifies 1111F as status I, meaning it is not valid for Medicare and Medicare uses a different code to report and pay for the service. As a CPT Category II code, it is a supplemental performance-tracking code and is never paid. It reports the reconciliation measure, not a dose or quantity of medication; documentation should support that the discharge medication list was reconciled with the current list.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 1111F pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

How the 1111F rate is calculated

Each of 1111F’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 1111F

1111F has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

1111F compared with similar codes

How to choose

1110FRecent dischargeWithin 60 days

1110F tracks a recent inpatient discharge. Use 1111F to report reconciliation of discharge medications with the current medication list.

99495Transitional care managementModerate complexity, visit within 14 days

99495 reports a transitional care management service. 1111F reports the medication-reconciliation performance measure, not the management service.

99496Transitional care managementHigh complexity, visit within 7 days

99496 reports a transitional care management service. 1111F reports the medication-reconciliation performance measure, not the management service.

Codes related to 1111F

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates