M1036 Adt no 180 dys pharmthry oud
Also known as: inadequate OUD treatment, brief addiction therapy
Patient is not taking pharmacotherapy for opioid use disorder or treatment duration is less than 180 days.
In Plain Language
Not receiving long-term addiction medication; Short-term opioid treatment
Clinical Context
Quality measure documenting gap in sustained treatment for opioid use disorder. Indicates potential opportunity for care improvement.
RVU Information
CPT M1036 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 M1036?
CPT M1036 (Adt no 180 dys pharmthry oud) is a M Codes code. Patient is not taking pharmacotherapy for opioid use disorder or treatment duration is less than 180 days.
Is M1036 covered by insurance?
M1036 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Quality measure documenting gap in sustained treatment for opioid use disorder. Indicates potential opportunity for care improvement.
When is CPT M1036 used?
Quality measure documenting gap in sustained treatment for opioid use disorder. Indicates potential opportunity for care improvement.
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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.