M1064 — Shingrix vaccine documented as administered or previously received
M1064 is a HCPCS Level II code for shingrix vaccine documented as administered or previously received. It belongs to the Medical Services section. It was terminated on December 31, 2020 and is not valid on new claims.
This code has been terminated
CMS terminated M1064 on December 31, 2020. It stays in the file as history — a claim you are auditing from before that date may legitimately carry it — but it must not appear on a new claim. The adjacent codes below are the usual place to look for its replacement.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
The CMS record for M1064
- Long descriptor
- Shingrix vaccine documented as administered or previously received
- Short descriptor
- Shing vac doc adm or pv rec
- Added
- January 1, 2019
- Terminated
- December 31, 2020
- BETOS
- Z2
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
When CMS retired it.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to M1064
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1064 is not quite right, the correct code is very often within a few positions of it.
- M1056Prescribed anticoagulant medication during the performance period, history of gi bleeding, history of intracranial bleeding, bleeding disorder and specific provider documented reasons: allergy to aspirin or anti-platelets, use of non-steroidal anti-inflammatory agents, drug-drug interaction, uncontrolled hypertension > 180/110 mmhg or gastroesophageal reflux disease
- M1057Aspirin or another antiplatelet therapy not used, reason not given
- M1058Patient was a permanent nursing home resident at any time during the performance period
- M1059Patient was in hospice or receiving palliative care at any time during the performance period
- M1060Patient died prior to the end of the performance period
- M1061Patient pregnancyterminated
- M1062Patient immunocompromisedterminated
- M1063Patients receiving high doses of immunosuppressive therapyterminated
- M1065Shingrix vaccine was not administered for reasons documented by clinician (e.g. patient administered vaccine other than shingrix, patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)terminated
- M1066Shingrix vaccine not documented as administered, reason not giventerminated
- M1067Hospice services for patient provided any time during the measurement period
- M1068Adults who are not ambulatory
- M1069Patient screened for future fall risk
- M1070Patient not screened for future fall risk, reason not given
- M1071Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomyterminated
- M1106The start of an episode of care documented in the medical record
Questions about M1064
What is HCPCS code M1064?
M1064 is a HCPCS Level II code for shingrix vaccine documented as administered or previously received. It sits in the Medical Services section.
Does Medicare cover M1064?
The CMS HCPCS file marks M1064 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
Is M1064 still valid?
No. M1064 was terminated on December 31, 2020 and should not be used on new claims.