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M1395 initial chemotherapy with def dur ec group

M Codes

Also known as: chemotherapy initiation, cancer treatment started, init chemo evidence-based

Performance measure documenting initiation of chemotherapy with defined duration within evidence-based clinical practice group guidelines. Tracks appropriate cancer treatment initiation.

In Plain Language

Starting chemotherapy for cancer; Beginning cancer drug treatment

Clinical Context

Documents appropriate initiation of chemotherapy per evidence-based guidelines with documented treatment plan for defined duration. Standard of care for eligible breast cancer patients.

RVU Information

CPT M1395 does not have a physician work RVU assigned by CMS. Reimbursement for this code is determined by payer-specific fee schedules.

Billing & Documentation

M-codes cover quality measures and performance reporting. They are used in value-based care programs to track whether specific clinical actions were taken. Documentation must support that the measured action was performed or a valid exclusion applies.

Specialties

OncologyMedical OncologyHematology-Oncology

Frequently Asked Questions

What is CPT code M1395?

CPT M1395 (initial chemotherapy with def dur ec group) is a M Codes code. Performance measure documenting initiation of chemotherapy with defined duration within evidence-based clinical practice group guidelines. Tracks appropriate cancer treatment initiation.

Is M1395 covered by insurance?

M1395 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Documents appropriate initiation of chemotherapy per evidence-based guidelines with documented treatment plan for defined duration. Standard of care for eligible breast cancer patients.

When is CPT M1395 used?

Documents appropriate initiation of chemotherapy per evidence-based guidelines with documented treatment plan for defined duration. Standard of care for eligible breast cancer patients.

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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.