M1396 Pt therapy clin trial
Also known as: clinical trial participation, research protocol treatment, pt ther clin trial
Performance measure documenting that the patient is enrolled in or receiving therapeutic clinical trial for breast cancer treatment. Captures clinical research participation.
In Plain Language
Enrolled in cancer research study; Participating in experimental cancer treatment
Clinical Context
Identifies patients receiving treatment through clinical trial protocols. Appropriate denominator exclusion from standard treatment measures.
RVU Information
CPT M1396 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
Frequently Asked Questions
What is CPT code M1396?
CPT M1396 (Pt therapy clin trial) is a M Codes code. Performance measure documenting that the patient is enrolled in or receiving therapeutic clinical trial for breast cancer treatment. Captures clinical research participation.
Is M1396 covered by insurance?
M1396 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Identifies patients receiving treatment through clinical trial protocols. Appropriate denominator exclusion from standard treatment measures.
When is CPT M1396 used?
Identifies patients receiving treatment through clinical trial protocols. Appropriate denominator exclusion from standard treatment measures.
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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.