M1020 — Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq-9 or phq-9m score was not assessed or is greater than or equal to 5
M1020 is a HCPCS Level II code for adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq-9 or phq-9m score was not assessed or is greater than or equal to 5. 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
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The CMS record for M1020
- Long descriptor
- Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq-9 or phq-9m score was not assessed or is greater than or equal to 5
- Short descriptor
- Adl pt mj dep ds no rs 12 mo
- 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 M1020
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1020 is not quite right, the correct code is very often within a few positions of it.
- 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
- M1021Patient had only urgent care visits during the performance period
- M1022Patients who were in hospice at any time during the performance periodterminated
- M1023Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than fiveterminated
- M1024Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five. either phq-9 or phq-9m score was not assessed or is greater than or equal to fiveterminated
- M1025Patients who were in hospice at any time during the performance periodterminated
- M1026Patients who were in hospice at any time during the performance periodterminated
- M1027Imaging of the head (ct or mri) was obtained
- M1028Documentation of patients with primary headache diagnosis and imaging other than ct or mri obtained
Questions about M1020
What is HCPCS code M1020?
M1020 is a HCPCS Level II code for adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq-9 or phq-9m score was not assessed or is greater than or equal to 5. It sits in the Medical Services section.
Does Medicare cover M1020?
The CMS HCPCS file marks M1020 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 M1020 paid under the physician fee schedule?
M1020 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.