M1035 – Adults who are deliberately phased out of medication assisted treatment (mat) prior to 180 days of continuous treatment
HCPCS Level II code · M codes: Medical Services and Quality Measures
HCPCS codeM1035
- Long description
- Adults who are deliberately phased out of medication assisted treatment (mat) prior to 180 days of continuous treatment
- Short description
- Adt pd out mat pr 180 dys tx
- Pricing indicator
00Not separately priced by Part B (bundled, not covered or Part A only)- Medicare coverage
CCarrier judgment – coverage decided by the Medicare contractor- BETOS category
Z2Undefined codes- Added
- January 1, 2019
- Last change
- January 1, 2019 – No change
Frequently asked questions
What is HCPCS code M1035?
M1035 is a HCPCS Level II code for adults who are deliberately phased out of medication assisted treatment (mat) prior to 180 days of continuous treatment.
Does Medicare cover M1035?
The HCPCS file lists coverage code C: Carrier judgment – coverage decided by the Medicare contractor. Coverage and payment also depend on local coverage determinations and the patient’s plan.
Nearby M codes
- M1027 – Imaging of the head (ct or mri) was obtained
- M1028 – Documentation of patients with primary headache diagnosis and imaging other than ct or mri obtained
- M1029 – Imaging of the head (ct or mri) was not obtained, reason not given
- M1030 – Patients with clinical indications for imaging of the head
- M1031 – Patients with no clinical indications for imaging of the head
- M1032 – Adults currently taking pharmacotherapy for oud
- M1033 – Pharmacotherapy for oud initiated after june 30th of performance period
- M1034 – Adults who have at least 180 days of continuous pharmacotherapy with a medication prescribed for oud without a gap of more than seven days
- M1036 – Adults who have not had at least 180 days of continuous pharmacotherapy with a medication prescribed for oud without a gap of more than seven days
- M1037 – Patients with a diagnosis of lumbar spine region cancer at the time of the procedure
- M1038 – Patients with a diagnosis of lumbar spine region fracture at the time of the procedure
- M1039 – Patients with a diagnosis of lumbar spine region infection at the time of the procedure
- M1040 – Patients with a diagnosis of lumbar idiopathic or congenital scoliosis
- M1041 – Patient had cancer, acute fracture or infection related to the lumbar spine or patient had neuromuscular, idiopathic or congenital lumbar scoliosis
- M1042 – Functional status measurement with score was obtained utilizing the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperatively
- M1043 – Functional status was not measured by the oswestry disability index (odi version 2.1a) at one year (9 to 15 months) postoperatively
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.