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M1135

M1135The start of an episode of care documented in the medical record

HCPCSActiveBETOS Z2

M1135 is a HCPCS Level II code for the start of an 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 M1135

Long descriptor
The start of an episode of care documented in the medical record

The official wording. This is what the code means.

Short descriptor
Start eoc doc med rec

CMS's 28-character form, which is what shows up on a remittance advice.

Added
January 1, 2020

When CMS introduced the code.

BETOS
Z2

Berenson-Eggers Type of Service — CMS's own analytic grouping.

Pricing indicator
00 — Not priced by Part B

Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.

Codes adjacent to M1135

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1135 is not quite right, the correct code is very often within a few positions of it.

  • M1127Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care
  • M1128Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record
  • M1129Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery
  • M1130Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
  • M1131Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care
  • M1132Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record
  • M1133Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery
  • M1134Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
  • M1136The start of an episode of care documented in the medical recordterminated
  • M1137Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of careterminated
  • M1138Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only)terminated
  • M1139Ongoing care not indicated, patient self-discharged early and seen only 1-2 visits (e.g., financial or insurance reasons, transportation problems, or reason unknown)terminated
  • M1140Ongoing care not indicated, patient discharged after only 1-2 visits due to specific medical events, documented in the medical record that make the treatment episode impossible such as the patient becomes hospitalized or scheduled for surgery for surgery or hospitalizedterminated
  • M1141Functional status was not measured by the oxford knee score (oks) or the knee injury and osteoarthritis outcome score joint replacement (koos, jr.) at one year (9 to 15 months) postoperatively
  • M1142Emergent cases
  • M1143Initiated episode of rehabilitation therapy, medical, or chiropractic care for neck impairment

Questions about M1135

What is HCPCS code M1135?

M1135 is a HCPCS Level II code for the start of an episode of care documented in the medical record. It sits in the Medical Services section.

Does Medicare cover M1135?

The CMS HCPCS file marks M1135 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 M1135 paid under the physician fee schedule?

M1135 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.

HCPCS Level II2026Q3-Jul· effective July 1, 2026