Does G0339 require prior authorization?

Yes, G0339 requires prior authorization (high confidence). At least one active policy explicitly requires prior authorization.

What is the Medicare reimbursement rate for G0339?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

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`G0339`, Image-guided robotic linear accelerator-based stereotactic radiosurgery,

HCPCS/CPT

Prior Authorization

Prior Auth Required

At least one active policy explicitly requires prior authorization (high confidence)

Medicare Pricing

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Documentation Required

All documentation must be available upon request and the medical record must support the medical necessity and frequency of treatment.
The medical record must document the critical nature of the anatomy or other circumstances necessitating stereotactic treatment, the patient's functional status including Karnofsky Performance Status, the treatment date(s), and the current treatment dose.
When requesting individual consideration at redetermination, providers must submit all relevant medical records and supporting literature, including at minimum two Phase II studies or one Phase III study for Contractor Medical Director review.
If billing more than allowed units of CPT 77334 (total units >6 or units > isocenters+3), document factors such as multiple isocenters, target volume irregularity, proximity to critical structures, or other reasons justifying additional dosimetry/treatment device units.
Diagnosis code(s) must accurately and specifically describe the patient's condition for which the stereotactic service was performed.
With IMRT planning and delivery, the physician must document consideration of other organs at risk (OAR) and adjacent critical structures.

Key Coverage Criteria

Stereotactic radiosurgery (SRS) is typically furnished as a single session; when more than one session is required, bill using stereotactic body radiation therapy (SBRT) codes instead of SRS codes.
Coverage on an individual (redetermination/appeal) basis may be considered for lesions that require a high radiation dose per fraction to avoid exposure of surrounding tissues when documentation and supporting literature are provided.
Radiation therapy is covered when the patient's medical record documents medical necessity consistent with LCD L39553.
Stereotactic Radiosurgery (SRS) or Stereotactic Body Radiation Therapy (SBRT) is covered for oligometastatic disease when documentation justifies aggressive local therapy to one or more metastatic deposits for total disease clearance or to reduce systemic disease burden with a specifically defined clinical benefit.
SRS or SBRT is covered for palliation or recurrent disease when tumor cannot be treated as effectively or safely by other radiotherapy methods due to proximity to previously irradiated volumes and beneficiary-unique facts are documented.
Radiation therapy for non-cancer diagnoses (e.g., epilepsy, trigeminal/facial nerve conditions, movement disorders, Parkinson's disease, tremor) may be covered only when prior therapies tried and failed are clearly documented with names, durations, and response.

20 Active Policies

A56874, Billing and Coding: Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)

NGS-J6-L35076, Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)

PALMETTO-JJ-L39553, Radiation Therapies

NGS-JK-L35076, Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)

PALMETTO-JM-L39553, Radiation Therapies

EVICORE-HPLAN-EMBLEM_GHI-8F6385AD7D76, GHI/Emblem Non-City of New York & Medicare Radiation Oncology Code List - Effective 01/01/2026

EVICORE-HPLAN-HEALTH_PARTNERS_PLANS-0414D494E567, Health Partners Plans Radiation Therapy Code List - Effective 01/01/2025

A59350, Billing and Coding: Radiation Therapies

UHC-POL-stereotactic-body-radiation-therapy-radiosurgery, Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery

AETNA-CPB-0707, Headaches: Invasive Procedures

AETNA-CPB-0083, Stereotactic Radiosurgery

AMBETTER-CP.MP.22, Stereotactic Body Radiation Therapy

REGENCE-MED49, Charged-Particle (Proton) Radiotherapy

REGENCE-SUR214, Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy for Tumors Outside of Intracranial, Skull Base, or Orbital Sites

REGENCE-SUR213, Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy of Intracranial, Skull Base, and Orbital Sites

UMR-POL-UMR-stereotactic-body-radiation-therapy-radiosurgery, Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery

SUREST-POL-SUREST-stereotactic-body-radiation-therapy-radiosurgery, Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery

UHCMA-POL-UHC_MA-radiation-oncologic-procedures, Radiation and Oncologic Procedures

EVICORE-HPLAN-AETNA-D84F393A3019, Aetna Radiation Oncology Code List - Effective 01/01/2026

CARELON-radiation-therapy-for-non-malignant-disease-2026-04-04, Radiation Therapy for Non Malignant Disease

Have a follow-up question?

Ask Backwork about documentation requirements, denial risks, or coverage in your state.

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G0339, Image-guided robotic linear accelerator-based stereotactic radiosurgery,

HCPCS/CPT

Prior Authorization

Prior Auth Required

At least one active policy explicitly requires prior authorization (high confidence)

Medicare Pricing

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Documentation Required

All documentation must be available upon request and the medical record must support the medical necessity and frequency of treatment.
The medical record must document the critical nature of the anatomy or other circumstances necessitating stereotactic treatment, the patient's functional status including Karnofsky Performance Status, the treatment date(s), and the current treatment dose.
When requesting individual consideration at redetermination, providers must submit all relevant medical records and supporting literature, including at minimum two Phase II studies or one Phase III study for Contractor Medical Director review.
If billing more than allowed units of CPT 77334 (total units >6 or units > isocenters+3), document factors such as multiple isocenters, target volume irregularity, proximity to critical structures, or other reasons justifying additional dosimetry/treatment device units.
Diagnosis code(s) must accurately and specifically describe the patient's condition for which the stereotactic service was performed.
With IMRT planning and delivery, the physician must document consideration of other organs at risk (OAR) and adjacent critical structures.

Key Coverage Criteria

Stereotactic radiosurgery (SRS) is typically furnished as a single session; when more than one session is required, bill using stereotactic body radiation therapy (SBRT) codes instead of SRS codes.
Coverage on an individual (redetermination/appeal) basis may be considered for lesions that require a high radiation dose per fraction to avoid exposure of surrounding tissues when documentation and supporting literature are provided.
Radiation therapy is covered when the patient's medical record documents medical necessity consistent with LCD L39553.
Stereotactic Radiosurgery (SRS) or Stereotactic Body Radiation Therapy (SBRT) is covered for oligometastatic disease when documentation justifies aggressive local therapy to one or more metastatic deposits for total disease clearance or to reduce systemic disease burden with a specifically defined clinical benefit.
SRS or SBRT is covered for palliation or recurrent disease when tumor cannot be treated as effectively or safely by other radiotherapy methods due to proximity to previously irradiated volumes and beneficiary-unique facts are documented.
Radiation therapy for non-cancer diagnoses (e.g., epilepsy, trigeminal/facial nerve conditions, movement disorders, Parkinson's disease, tremor) may be covered only when prior therapies tried and failed are clearly documented with names, durations, and response.

20 Active Policies

A56874, Billing and Coding: Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)

NGS-J6-L35076, Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)

PALMETTO-JJ-L39553, Radiation Therapies

NGS-JK-L35076, Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)

PALMETTO-JM-L39553, Radiation Therapies

EVICORE-HPLAN-EMBLEM_GHI-8F6385AD7D76, GHI/Emblem Non-City of New York & Medicare Radiation Oncology Code List - Effective 01/01/2026

EVICORE-HPLAN-HEALTH_PARTNERS_PLANS-0414D494E567, Health Partners Plans Radiation Therapy Code List - Effective 01/01/2025

A59350, Billing and Coding: Radiation Therapies

UHC-POL-stereotactic-body-radiation-therapy-radiosurgery, Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery

AETNA-CPB-0707, Headaches: Invasive Procedures

AETNA-CPB-0083, Stereotactic Radiosurgery

AMBETTER-CP.MP.22, Stereotactic Body Radiation Therapy

REGENCE-MED49, Charged-Particle (Proton) Radiotherapy

REGENCE-SUR214, Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy for Tumors Outside of Intracranial, Skull Base, or Orbital Sites

REGENCE-SUR213, Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy of Intracranial, Skull Base, and Orbital Sites

UMR-POL-UMR-stereotactic-body-radiation-therapy-radiosurgery, Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery

SUREST-POL-SUREST-stereotactic-body-radiation-therapy-radiosurgery, Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery

UHCMA-POL-UHC_MA-radiation-oncologic-procedures, Radiation and Oncologic Procedures

EVICORE-HPLAN-AETNA-D84F393A3019, Aetna Radiation Oncology Code List - Effective 01/01/2026

CARELON-radiation-therapy-for-non-malignant-disease-2026-04-04, Radiation Therapy for Non Malignant Disease

Have a follow-up question?

Ask Backwork about documentation requirements, denial risks, or coverage in your state.

Ask Backwork about G0339 Sign up free

`G0339`, Image-guided robotic linear accelerator-based stereotactic radiosurgery,

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

`G0339`, Image-guided robotic linear accelerator-based stereotactic radiosurgery,

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

G0339, Image-guided robotic linear accelerator-based stereotactic radiosurgery,

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

G0339, Image-guided robotic linear accelerator-based stereotactic radiosurgery,

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

`G0339`, Image-guided robotic linear accelerator-based stereotactic radiosurgery,

`G0339`, Image-guided robotic linear accelerator-based stereotactic radiosurgery,