M1035 Adt pd out mat pr 180 dys treatment
Also known as: paid outpatient OUD program, insurance-covered addiction treatment
Patient is taking paid outpatient medication programs for opioid use disorder for at least 180 days of treatment.
In Plain Language
Insurance covers addiction treatment; Paid outpatient drug therapy program
Clinical Context
Quality measure documenting sustained engagement in insurance-covered outpatient medication treatment for opioid use disorder.
RVU Information
CPT M1035 does not have a physician work RVU assigned by CMS. Reimbursement for this code is determined by payer-specific fee schedules.
Billing & Documentation
M-codes cover quality measures and performance reporting. They are used in value-based care programs to track whether specific clinical actions were taken. Documentation must support that the measured action was performed or a valid exclusion applies.
Specialties
Frequently Asked Questions
What is CPT code M1035?
CPT M1035 (Adt pd out mat pr 180 dys treatment) is a M Codes code. Patient is taking paid outpatient medication programs for opioid use disorder for at least 180 days of treatment.
Is M1035 covered by insurance?
M1035 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Quality measure documenting sustained engagement in insurance-covered outpatient medication treatment for opioid use disorder.
When is CPT M1035 used?
Quality measure documenting sustained engagement in insurance-covered outpatient medication treatment for opioid use disorder.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.