M1065 – Shingrix vaccine was not administered for reasons documented by clinician (e.g. patient administered vaccine other than shingrix, patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)
HCPCS Level II code · M codes: Medical Services and Quality Measures
HCPCS codeM1065
- Long description
- Shingrix vaccine was not administered for reasons documented by clinician (e.g. patient administered vaccine other than shingrix, patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)
- Short description
- Shing vac no adm clinc rsn
- Pricing indicator
00Not separately priced by Part B (bundled, not covered or Part A only)- Medicare coverage
CCarrier judgment – coverage decided by the Medicare contractor- BETOS category
Z2Undefined codes- Added
- January 1, 2019
- Last change
- January 1, 2021 – No change
- Termination date
- December 31, 2020
Frequently asked questions
What is HCPCS code M1065?
M1065 is a HCPCS Level II code for shingrix vaccine was not administered for reasons documented by clinician (e.g. patient administered vaccine other than shingrix, patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons). It was discontinued on December 31, 2020.
Does Medicare cover M1065?
The HCPCS file lists coverage code C: Carrier judgment – coverage decided by the Medicare contractor. Coverage and payment also depend on local coverage determinations and the patient’s plan.
Nearby M codes
- M1057 – Aspirin or another antiplatelet therapy not used, reason not given
- M1058 – Patient was a permanent nursing home resident at any time during the performance period
- M1059 – Patient was in hospice or receiving palliative care at any time during the performance period
- M1060 – Patient died prior to the end of the performance period
- M1061 – Patient pregnancy
- M1062 – Patient immunocompromised
- M1063 – Patients receiving high doses of immunosuppressive therapy
- M1064 – Shingrix vaccine documented as administered or previously received
- M1066 – Shingrix vaccine not documented as administered, reason not given
- M1067 – Hospice services for patient provided any time during the measurement period
- M1068 – Adults who are not ambulatory
- M1069 – Patient screened for future fall risk
- M1070 – Patient not screened for future fall risk, reason not given
- M1071 – Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy
- M1106 – The start of an episode of care documented in the medical record
- M1107 – Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.