S0136 Clozapine, 25 milligrams
Also known as: Clozaril, clozapine, atypical antipsychotic
Clozapine oral medication at 25 milligrams, an atypical antipsychotic.
In Plain Language
schizophrenia medication; antipsychotic; psychosis treatment
Clinical Context
Used for treatment-resistant schizophrenia and severe bipolar disorder. Requires regular blood monitoring for agranulocytosis.
RVU Information
CPT S0136 does not have a physician work RVU assigned by CMS. This is typical for supply, drug, and equipment codes — reimbursement is based on Average Sales Price (ASP), fee schedules, or payer contracts rather than the RVU system.
Billing & Documentation
S-codes are used by private payers (not Medicare) for services without a standard CPT or HCPCS code. Coverage varies significantly between insurers. Verify payer acceptance before billing and document medical necessity thoroughly.
Specialties
Frequently Asked Questions
What is CPT code S0136?
CPT S0136 (Clozapine, 25 milligrams) is a S Codes code. Clozapine oral medication at 25 milligrams, an atypical antipsychotic.
Is S0136 covered by insurance?
S0136 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Used for treatment-resistant schizophrenia and severe bipolar disorder. Requires regular blood monitoring for agranulocytosis.
When is CPT S0136 used?
Used for treatment-resistant schizophrenia and severe bipolar disorder. Requires regular blood monitoring for agranulocytosis.
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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.