M0003 HCPCS code: Optimal care for patients with episodic neurological conditions mips value pathways
M0003 is the HCPCS Level II code for optimal care for patients with episodic neurological conditions mips value pathways. CMS terminated M0003 on 2024-12-31; do not bill it for later dates of service. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case.
Code details
| Field | Value |
|---|---|
| Section | M codes — Medical services and quality measures |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | Z2 |
| Added | 2023-01-01 |
| Last action effective | 2025-01-01 |
| Terminated | 2024-12-31 |
What changed for M0003
- 2023-01-01: M0003 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code M0003?
M0003 is the HCPCS Level II code for optimal care for patients with episodic neurological conditions mips value pathways. Short descriptor: "Opt care episod neuro mvp".
Does Medicare cover M0003?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related M00 codes
- M0001 — Advancing cancer care mips value pathways
- M0002 — Optimal care for kidney health mips value pathways
- M0004 — Quality care for patients with neurological conditions mips value pathway
- M0005 — Value in primary care mips value pathway
- M0010 — Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services
- M0064 — Brief office visit for the sole purpose of monitoring or changing drug prescriptions used in the treatment of mental psychoneurotic and personality disorders
- M0075 — Cellular therapy
- M0076 — Prolotherapy
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Next steps
- Run a reimbursement report for a device billed under M0003
- Watch M0003 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for M0003
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.