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See a sample rate comparisonHCPCS M1020 Fee Schedule
HCPCS M1020 is classified under Screening Procedures, in the Adolescent Depression, Remission AND Management subgroup.
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
| Key Fact | Detail |
|---|---|
| Service Type | Screening Procedures Adolescent Depression, Remission AND Management |
| Complexity Level | Low |
National average reimbursement for HCPCS M1020 by major payers:
$70.12
BCBS / Anthem
$N/A
UnitedHealthcare
$49.42
Aetna
$0.00
Cigna
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HCPCS M1020
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See a sample payer proposalHCPCS M1020 vs. Other Adolescent Depression, Remission AND Management Codes
The table lists codes related to M1020. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| M1019-HCPCS | Low | Adolescent 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 |
| M1020-HCPCS | Low | 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 |
| M1021-HCPCS | Low | Patient had only urgent care visits during the performance period |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS M1020. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the M1020 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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