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M1414 HCPCS Level II code: Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor…

M1414 is the HCPCS code for “Documentation 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 in an urgent or…” in CMS’s October 2026 release, in effect from Oct 1, 2026.

Official description

M1414

Documentation 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 in an urgent or emergent situation where delay of treatment would jeopardize the patient's health status; other medical reasons/contraindication)

Short description: Med rsn no pdl1 bef 1st ther

HCPCS · United States

Medicare details

The indicators CMS publishes with M1414 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 M1414 sits

  1. 1M codesMedical services and quality measures
  2. 2Active code 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 in an urgent or emergent situation where delay of treatment would jeopardize the patient's health status; other medical reasons/contraindication)

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.

See M1414 in the CMS source

Frequently asked questions

What does HCPCS code M1414 mean?

M1414 is the HCPCS code for “Documentation 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 in an urgent or emergent situation where delay of treatment would jeopardize the patient's health status; other medical reasons/contraindication)” in CMS’s HCPCS Level II October 2026 release.

Does Medicare cover M1414?

CMS lists M1414’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 M1414

M1408Patients 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…M1413Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapyM1415Patients 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 vaccinationM1420Complete ophthalmologic care mips value pathway