Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under "denominator note" or the long-acting injectable antipsychotic medications listed under "denominator note"
Code effective Jan 01, 2025
HCPCS Section
Medical services
M1380 is a valid 2026 HCPCS code meaning Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under "denominator note" or the long-acting injectable antipsychotic medications listed under "denominator note" or (2 rx in perf pd any com meds) for short. HCPCS M1380 has been effective since 01/01/2025 and applies to Medical care.
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HCPCS Level II Code Section M - Medical services |
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| HCPCS Code | M1380 |
|---|---|
| Description |
Long description:
Short description: |
| HCPCS Pricing indicator |
00 - Physician Fee Schedule And Non-Physician Practitioners - Service not separately priced by part B (e.g., services not covered, bundled, used by Part A only, etc.)
|
| Multiple pricing indicator |
9 - Not applicable as HCPCS not priced separately by part B or value is not established
|
| Coverage code | C - Carrier judgment |
| BETOS2 code | Z2 - Undefined codes |
| HCPCS Action code | N - No maintenance for this code |
| Type of service | 1 - Medical care |
| Effective date | Effective Jan 01, 2025 |
| Date added | Added Jan 01, 2025 |
1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).
2 BETOS stands for “Berenson-Eggers Type Of Service”
HCPCS Level II codes and descriptors are approved and maintained jointly by the alpha-numeric editorial panel (consisting of CMS, the Health Insurance Association of America, and the Blue Cross and Blue Shield Association). — Updated 6/3/2026
CPT® is a registered trademark of the American Medical Association (AMA). All rights reserved.