13 commercial payer policies list 77402. 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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13 policies from 10 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 77402 |
|---|---|---|
| Radiation Therapy (excludes Proton) | Apr 4, 2026 | Covered |
| Radiation Therapy for Non-Malignant Disease | Apr 4, 2026 | Covered |
| Policy | Effective | Status of 77402 |
|---|---|---|
| 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 77402 |
|---|---|---|
| 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 77402 |
|---|---|---|
| Aetna Radiation Oncology Code List | Jan 1, 2026 | Prior auth required |
| Policy | Effective | Status of 77402 |
|---|---|---|
| Radiation Therapy for Skin Cancer | Not recorded | Covered |
| Policy | Effective | Status of 77402 |
|---|---|---|
| Treatment of Keloids and Scar Revision | Jul 1, 2026 | Covered |
| Policy | Effective | Status of 77402 |
|---|---|---|
| GHI/Emblem Non-City of New York & Medicare Radiation Oncology Code List | Jan 1, 2026 | Prior auth required |
| Policy | Effective | Status of 77402 |
|---|---|---|
| Health Partners Plans Radiation Therapy Code List | Jan 1, 2025 | Prior auth required |
| Policy | Effective | Status of 77402 |
|---|---|---|
| Radiation Therapy: Fractionation, Image-Guidance, and Special Services | Mar 1, 2026 | Covered |
| Policy | Effective | Status of 77402 |
|---|---|---|
| Radiation and Oncologic Procedures | Not recorded | Covered |