M1404 — Patients on a therapeutic clinical trial
M1404 is a HCPCS Level II code for patients on a therapeutic clinical trial. It belongs to the Medical Services section. Whether Medicare pays it depends on the coverage rule below.
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.
Physician fee schedule statusM
Measurement code. Used for reporting purposes only; never paid.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
The CMS record for M1404
- Long descriptor
- Patients on a therapeutic clinical trial
- Short descriptor
- Pt ther clin trial
- Added
- January 1, 2025
- 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.
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 M1404
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1404 is not quite right, the correct code is very often within a few positions of it.
- M1396Patients on a therapeutic clinical trial
- M1397Patients with recurrence/disease progression
- M1398Patients with baseline and follow-up promis surveys documented in the medical record
- M1399Patients who leave the practice during the follow-up period
- M1400Patients who died during the follow-up period
- M1401Stages i-iii breast cancer
- M1402Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group
- M1403Patients with baseline and follow-up promis surveys documented in the medical record
- M1405Patients with recurrence/disease progression
- M1406Patients who leave the practice during the follow-up period
- M1407Patients who died during the follow-up period
- M1408Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer
- M1409Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis
- M1410Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis
- M1411Currently on first-line immune checkpoint inhibitors without chemotherapy
- M1412Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skipping mutation, and ret rearrangement
Questions about M1404
What is HCPCS code M1404?
M1404 is a HCPCS Level II code for patients on a therapeutic clinical trial. It sits in the Medical Services section.
Does Medicare cover M1404?
The CMS HCPCS file marks M1404 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.
How is M1404 paid under the physician fee schedule?
M1404 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.