M1433 HCPCS Level II code: Patient on oral chemotherapy on or within 30 days before denominator eligible encounter
M1433 is the HCPCS code for “Patient on oral chemotherapy on or within 30 days before denominator eligible encounter” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
M1433Patient on oral chemotherapy on or within 30 days before denominator eligible encounter
Short description: Oral chemo wthn 30 days enc
HCPCS · United States
Medicare details
The indicators CMS publishes with M1433 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, 2026
Where M1433 sits
- 1M codesMedical services and quality measures
- 2Active code M1433Patient on oral chemotherapy on or within 30 days before denominator eligible encounter
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 M1433 mean?
M1433 is the HCPCS code for “Patient on oral chemotherapy on or within 30 days before denominator eligible encounter” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover M1433?
CMS lists M1433’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 M1433
All M codesM1427Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)M1428Patients who have bilateral absence of eyes any time during the patient's history through the end of the measurement periodM1429Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documentedM1430Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)M1431Encounters conducted via telehealthM1432Encounters conducted via telehealthM1434Patient on oral chemotherapy on or within 30 days after denominator eligible encounterM1435Patient on oral chemotherapy during the performance periodM1436Encounters conducted via telehealthM1437Encounters conducted via telehealthM1438Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)M1439Significant ocular conditions that impact the visual outcome of surgery