M1396 HCPCS Level II code: Patients on a therapeutic clinical trial
M1396 is the HCPCS code for “Patients on a therapeutic clinical trial” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
M1396Patients on a therapeutic clinical trial
Short description: Pt ther clin trial
HCPCS · United States
Medicare details
The indicators CMS publishes with M1396 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Carrier judgment
- Medicare pricing
- Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)
- Type of service
- Medical care
- BETOS category
- Undefined codes
- Added
- Jan 1, 2025
Where M1396 sits
- 1M codesMedical services and quality measures
- 2Active code M1396Patients on a therapeutic clinical trial
Source and release
- Data release
- HCPCS Level II · October 2026
- Effective date
- Oct 1, 2026
- Publisher
- CMS
This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.
Frequently asked questions
What does HCPCS code M1396 mean?
M1396 is the HCPCS code for “Patients on a therapeutic clinical trial” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover M1396?
CMS lists M1396’s Medicare coverage as “Carrier judgment” and its pricing as “Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.
Which HCPCS Level II release does this page use?
It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.
Codes beside M1396
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