S0136 — Clozapine, 25 mg
S0136 is a HCPCS Level II code for clozapine, 25 mg. It belongs to the Temporary National Codes (Non-Medicare) section. Medicare does not pay it — see the coverage note below before you bill it.
Medicare coverage: Not payable by Medicare
Medicare does not pay this code. It may still be valid for another payer, but a Medicare claim carrying it will not be reimbursed.
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 statusI
Not valid for Medicare purposes. Medicare uses another code.
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 S0136
- Long descriptor
- Clozapine, 25 mg
- Short descriptor
- Clozapine, 25 mg
- Added
- April 1, 2003
- 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 S0136
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If S0136 is not quite right, the correct code is very often within a few positions of it.
- S0108Mercaptopurine, oral, 50 mg
- S0109Methadone, oral, 5 mg
- S0117Tretinoin, topical, 5 grams
- S0119Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code)
- S0122Injection, menotropins, 75 iu
- S0126Injection, follitropin alfa, 75 iu
- S0128Injection, follitropin beta, 75 iu
- S0132Injection, ganirelix acetate, 250 mcg
- S0137Didanosine (ddi), 25 mg
- S0138Finasteride, 5 mg
- S0139Minoxidil, 10 mg
- S0140Saquinavir, 200 mg
- S0142Colistimethate sodium, inhalation solution administered through dme, concentrated form, per mg
- S0144Injection, propofol, 10 mgterminated
- S0145Injection, pegylated interferon alfa-2a, 180 mcg per ml
- S0148Injection, pegylated interferon alfa-2b, 10 mcg
Questions about S0136
What is HCPCS code S0136?
S0136 is a HCPCS Level II code for clozapine, 25 mg. It sits in the Temporary National Codes (Non-Medicare) section.
Does Medicare cover S0136?
The CMS HCPCS file marks S0136 as "Not payable by Medicare". Medicare does not pay this code. It may still be valid for another payer, but a Medicare claim carrying it will not be reimbursed.
How is S0136 paid under the physician fee schedule?
S0136 carries PFS status code I. Not valid for Medicare purposes. Medicare uses another code.