M1028 — Documentation of patients with primary headache diagnosis and imaging other than ct or mri obtained
M1028 is a HCPCS Level II code for documentation of patients with primary headache diagnosis and imaging other than ct or mri obtained. 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 M1028
- Long descriptor
- Documentation of patients with primary headache diagnosis and imaging other than ct or mri obtained
- Short descriptor
- Doc of pt prm hda dx and otr
- 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 M1028
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1028 is not quite right, the correct code is very often within a few positions of it.
- M1020Adolescent 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
- 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
- M1029Imaging of the head (ct or mri) was not obtained, reason not given
- M1030Patients with clinical indications for imaging of the headterminated
- M1031Patients with no clinical indications for imaging of the headterminated
- M1032Adults currently taking pharmacotherapy for oud
- M1033Pharmacotherapy for oud initiated after june 30th of performance periodterminated
- M1034Adults who have at least 180 days of continuous pharmacotherapy with a medication prescribed for oud without a gap of more than seven days
- M1035Adults who are deliberately phased out of medication assisted treatment (mat) prior to 180 days of continuous treatment
- 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
Questions about M1028
What is HCPCS code M1028?
M1028 is a HCPCS Level II code for documentation of patients with primary headache diagnosis and imaging other than ct or mri obtained. It sits in the Medical Services section.
Does Medicare cover M1028?
The CMS HCPCS file marks M1028 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 M1028 paid under the physician fee schedule?
M1028 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.