HCPCS Level II · Medical services and quality measures
M1036Adults 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
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Source: CMS HCPCS quarterly update, October 2026. Page updated September 29, 2026.
About M1036
M1036 is an HCPCS Level II code in the M series (medical services and quality measures), describing 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.
It was added to HCPCS effective 01/01/2019.
Its Medicare coverage code is "C", meaning coverage is left to the Medicare contractor's judgment.
Details
- Short description
- Adt no 180 dys pharmthry oud
- Date added
- 01/01/2019
- Action effective
- 01/01/2019
- BETOS
- Z2
Related M10xx codes
- M1003Tb screening performed and results interpreted within twelve months prior to initiation of first-time biologic and/or immune response modifier therapy
- M1004Documentation of medical reason for not screening for tb or interpreting results (i.e., patient positive for tb and documentation of past treatment; patient who has recently completed a course of anti-tb therapy)
- M1005Tb screening not performed or results not interpreted, reason not given
- M1006Disease activity not assessed, reason not given
- M1007>=50% of total number of a patient's outpatient ra encounters assessed
- M1008<50% of total number of a patient's outpatient ra encounters assessed
- M1009Discharge/discontinuation of the episode of care documented in the medical record
- M1010Discharge/discontinuation of the episode of care documented in the medical record
- M1011Discharge/discontinuation of the episode of care documented in the medical record
- M1012Discharge/discontinuation of the episode of care documented in the medical record
- M1013Discharge/discontinuation of the episode of care documented in the medical record
- M1014Discharge/discontinuation of the episode of care documented in the medical record
Common questions about M1036
Is HCPCS M1036 still valid?
- Yes. M1036 is active in the CMS October 2026 HCPCS file.
Does Medicare cover M1036?
- Its coverage code is "C": coverage is left to the Medicare contractor's judgment. Check the local coverage determination for your region.