M1011 — Discharge/discontinuation of the episode of care documented in the medical record
M1011 is a HCPCS Level II code for discharge/discontinuation of the episode of care documented in the medical record. It belongs to the Medical Services section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusM
Measurement code. Used for reporting purposes only; never paid.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
The CMS record for M1011
- Long descriptor
- Discharge/discontinuation of the episode of care documented in the medical record
- Short descriptor
- Dc eoc doc med rec
- Added
- January 1, 2019
- BETOS
- Z2
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to M1011
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1011 is not quite right, the correct code is very often within a few positions of it.
- 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
- 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
- M1015Discharge/discontinuation of the episode of care documented in the medical recordterminated
- M1016Female patients unable to bear children
- M1017Patient admitted to palliative care servicesterminated
- M1018Patients with an active diagnosis or history of cancer (except basal cell and squamous cell skin carcinoma), patients who are heavy tobacco smokers, lung cancer screening patients
- M1019Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5
Questions about M1011
What is HCPCS code M1011?
M1011 is a HCPCS Level II code for discharge/discontinuation of the episode of care documented in the medical record. It sits in the Medical Services section.
Does Medicare cover M1011?
The CMS HCPCS file marks M1011 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is M1011 paid under the physician fee schedule?
M1011 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.