M1434 — Patient on oral chemotherapy on or within 30 days after denominator eligible encounter
M1434 is a HCPCS Level II code for patient on oral chemotherapy on or within 30 days after denominator eligible encounter. It belongs to the Medical Services section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
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 statusM
Measurement code. Used for reporting purposes only; never paid.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
The CMS record for M1434
- Long descriptor
- Patient on oral chemotherapy on or within 30 days after denominator eligible encounter
- Short descriptor
- Orl chemo wthn 30 d post enc
- Added
- January 1, 2026
- BETOS
- Z2
- 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 M1434
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1434 is not quite right, the correct code is very often within a few positions of it.
- M1426Encounters conducted via telehealth
- M1427Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)
- M1428Patients who have bilateral absence of eyes any time during the patient's history through the end of the measurement period
- M1429Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented
- M1430Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)
- M1431Encounters conducted via telehealth
- M1432Encounters conducted via telehealth
- M1433Patient on oral chemotherapy on or within 30 days before denominator eligible encounter
- M1435Patient on oral chemotherapy during the performance period
- M1436Encounters conducted via telehealth
- M1437Encounters conducted via telehealth
- M1438Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)
- M1439Significant ocular conditions that impact the visual outcome of surgery
- M1440Encounters conducted via telehealth
- M1441Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient
- M1442Encounters conducted via telehealth
Questions about M1434
What is HCPCS code M1434?
M1434 is a HCPCS Level II code for patient on oral chemotherapy on or within 30 days after denominator eligible encounter. It sits in the Medical Services section.
Does Medicare cover M1434?
The CMS HCPCS file marks M1434 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is M1434 paid under the physician fee schedule?
M1434 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.