M1413 HCPCS Level II code: Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy
M1413 is the HCPCS code for “Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
M1413Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy
Short description: Pos pdl1 bef init ici tx
HCPCS · United States
Medicare details
The indicators CMS publishes with M1413 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 M1413 sits
- 1M codesMedical services and quality measures
- 2Active code M1413Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy
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 M1413 mean?
M1413 is the HCPCS code for “Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover M1413?
CMS lists M1413’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 M1413
All M codesM1407Patients who died during the follow-up periodM1408Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancerM1409Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosisM1410Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosisM1411Currently on first-line immune checkpoint inhibitors without chemotherapyM1412Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved…M1414Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is…M1415Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapyM1416Patient received hospice services any time during the performance periodM1417Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccinationM1418Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by…M1419Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination