CPT code 1111F: Medication reconciliation, quality measure2026 Medicare rate & RVUs in Guam
Reports completion of reconciling a patient's discharge medications with the current medication list as a CPT Category II performance measure.
CMS doesn’t publish an office rate for 1111F in Guam.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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.
1111F in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | Unavailable | Unavailable |
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.
How the rate is built · 1111F
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
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.
Place of service · 1111F
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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1111F isn’t priced in this setting.
1111F compared with similar codes
Compare codes · National
4 codes, side by side
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.
1111F billing questions
What does 1111F document?
It reports reconciliation of the patient's discharge medications with the current medication list.
How is 1111F different from 1110F?
1110F tracks a recent inpatient discharge; 1111F tracks reconciliation of discharge medications with the current medication list.
Can 1111F be billed as a separate Medicare service?
No. Medicare status I identifies 1111F as not valid for Medicare, and CPT Category II codes are supplemental tracking codes that are never paid.
How many units should be reported?
The code tracks completion of medication reconciliation, not a medication dose or quantity.
What documentation supports 1111F?
The record should support that the discharge medications were reconciled with the current medication list.
Does 1111F report transitional care management?
No. 1111F reports the medication-reconciliation measure; 99495 and 99496 report transitional care management services.
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
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