Radiation Therapies
JJ · Effective Dec 3, 2023
3 active Medicare policies list 77301, and 33 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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JJ · Effective Dec 3, 2023
JM · Effective Dec 3, 2023
National · Effective Oct 1, 2026
33 policies from 13 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 77301 |
|---|---|---|
| Charged-Particle (Proton) Radiotherapy | Oct 1, 2025 | Covered |
| Intensity Modulated Radiotherapy (IMRT) for Breast Cancer | Jan 1, 2026 | Covered |
| Intensity Modulated Radiotherapy (IMRT) for Tumors in Close Proximity to Organs at Risk | Jan 1, 2026 | Covered |
| Intensity Modulated Radiotherapy (IMRT) of the Central Nervous System (CNS), Head, Neck, and Thyroid | Jan 1, 2026 | Covered |
| Intensity Modulated Radiotherapy (IMRT) of the Thorax, Abdomen, Pelvis, and Extremities | Jan 1, 2026 | Covered |
| Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy for Tumors Outside of Intracranial, Skull Base, or Orbital Sites |
| Nov 1, 2025 |
| Covered |
| Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy of Intracranial, Skull Base, and Orbital Sites | Nov 1, 2025 | Covered |
|---|
| Policy | Effective | Status of 77301 |
|---|---|---|
| Intensity-Modulated Radiation Therapy | Mar 1, 2026 | Covered |
| Proton Beam Radiation Therapy | Mar 1, 2026 | Covered |
| Radiation Therapy: Fractionation, Image-Guidance, and Special Services | Mar 1, 2026 | Covered |
| Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 77301 |
|---|---|---|
| Proton Beam Therapy | Mar 23, 2025 | Covered |
| Radiation Therapy (excludes Proton) | Apr 4, 2026 | Covered |
| Radiation Therapy for Non-Malignant Disease | Apr 4, 2026 | Covered |
| Policy | Effective | Status of 77301 |
|---|---|---|
| Intensity-Modulated Radiation Therapy | Mar 1, 2026 | Covered |
| Proton Beam Radiation Therapy | Mar 1, 2026 | Covered |
| Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 77301 |
|---|---|---|
| Intensity-Modulated Radiation Therapy | Mar 1, 2026 | Covered |
| Proton Beam Radiation Therapy | Mar 1, 2026 | Covered |
| Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 77301 |
|---|---|---|
| Intensity-Modulated Radiotherapy | Not recorded | Covered |
| Radiation Therapy for Skin Cancer | Not recorded | Covered |
| Policy | Effective | Status of 77301 |
|---|---|---|
| Cigna Commercial Radiation Oncology Code List | Mar 7, 2026 | Prior auth required |
| Cigna Comprehensive Code List | Mar 7, 2026 | Prior auth required |
| Policy | Effective | Status of 77301 |
|---|---|---|
| Cigna Commercial & Medicare Advantage Radiation Oncology Code List | Jan 1, 2026 | Prior auth required |
| Cigna OBM Radiation Oncology Code List | Jan 1, 2026 | Prior auth required |
| Policy | Effective | Status of 77301 |
|---|---|---|
| eviCore Radiation Oncology Coding Guidelines | Jan 1, 2021 | Covered |
| eviCore Radiation Therapy Coding Guidelines | Jan 1, 2019 | Covered with conditions |
| Policy | Effective | Status of 77301 |
|---|---|---|
| Intensity Modulated Radiation Therapy | Mar 2, 2026 | Covered |
| Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy | Feb 2, 2026 | Covered |
| Policy | Effective | Status of 77301 |
|---|---|---|
| Intensity Modulated Radiation Therapy | Sep 7, 2023 | Covered |
| Policy | Effective | Status of 77301 |
|---|---|---|
| GHI/Emblem Non-City of New York & Medicare Radiation Oncology Code List | Jan 1, 2026 | Prior auth required |
| Policy | Effective | Status of 77301 |
|---|---|---|
| Radiation and Oncologic Procedures | Not recorded | Covered |