M0076 — Prolotherapy
M0076 is a HCPCS Level II code for prolotherapy. It belongs to the Medical Services section. Medicare does not pay it — see the coverage note below before you bill it.
Medicare coverage: Non-covered by Medicare
Medicare does not cover the item or service this code describes.
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 statusN
Non-covered service. Medicare does not cover it.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of M0076 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for M0076
- Long descriptor
- Prolotherapy
- Short descriptor
- Prolotherapy
- Added
- January 1, 1986
- BETOS
- Y2
- 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 M0076
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M0076 is not quite right, the correct code is very often within a few positions of it.
- M0001Advancing cancer care mips value pathways
- M0002Optimal care for kidney health mips value pathways
- M0003Optimal care for patients with episodic neurological conditions mips value pathwaysterminated
- M0004Quality care for patients with neurological conditions mips value pathway
- M0005Value in primary care mips value pathway
- M0010Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services
- M0064Brief office visit for the sole purpose of monitoring or changing drug prescriptions used in the treatment of mental psychoneurotic and personality disordersterminated
- M0075Cellular therapy
- M0100Intragastric hypothermia using gastric freezing
- M0201Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patient's home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patient's home
- M0220Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), includes injection and post administration monitoringterminated
- M0221Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), includes injection and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergencyterminated
- M0222Intravenous injection, bebtelovimab, includes injection and post administration monitoringterminated
- M0223Intravenous injection, bebtelovimab, includes injection and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergencyterminated
- M0224Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments, includes infusion and post administration monitoring
- M0231Intravenous infusion, tocilizumabbavi, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation only, includes infusion and post administration monitoring, first dose
Questions about M0076
What is HCPCS code M0076?
M0076 is a HCPCS Level II code for prolotherapy. It sits in the Medical Services section.
Does Medicare cover M0076?
The CMS HCPCS file marks M0076 as "Non-covered by Medicare". Medicare does not cover the item or service this code describes.
How is M0076 paid under the physician fee schedule?
M0076 carries PFS status code N. Non-covered service. Medicare does not cover it.