Proton Beam Radiotherapy
J9 · Effective Oct 1, 2015
7 active Medicare policies list 77522, and 19 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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J9 · Effective Oct 1, 2015
J15 · Effective Oct 24, 2016
J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
J6 · Effective Apr 1, 2026
National · Effective Oct 1, 2025
National · Effective Oct 2, 2025
19 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 77522 |
|---|---|---|
| Proton Beam Therapy | Mar 23, 2025 | Covered |
| Radiation Therapy (excludes Proton) | Apr 4, 2026 | Covered |
| Policy | Effective | Status of 77522 |
|---|---|---|
| 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 77522 |
|---|---|---|
| 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 77522 |
|---|---|---|
| Intensity-Modulated Radiation Therapy | Mar 1, 2026 | Covered |
| Proton Beam Radiation Therapy | Mar 1, 2026 | Covered |
| Policy | Effective | Status of 77522 |
|---|---|---|
| Intensity-Modulated Radiation Therapy | Mar 1, 2026 | Covered |
| Proton Beam Radiation Therapy | Mar 1, 2026 | Covered |
| Policy | Effective | Status of 77522 |
|---|---|---|
| Intensity-Modulated Radiation Therapy | Mar 1, 2026 | Covered |
| Proton Beam Radiation Therapy | Mar 1, 2026 | Covered |
| Policy | Effective | Status of 77522 |
|---|---|---|
| Aetna Radiation Oncology Code List | Jan 1, 2026 | Prior auth required |
| Policy | Effective | Status of 77522 |
|---|---|---|
| Proton and Neutron Beam Therapies | Not recorded | Covered |
| Policy | Effective | Status of 77522 |
|---|---|---|
| GHI/Emblem Non-City of New York & Medicare Radiation Oncology Code List | Jan 1, 2026 | Prior auth required |
| Policy | Effective | Status of 77522 |
|---|---|---|
| Health Partners Plans Radiation Therapy Code List | Jan 1, 2025 | Prior auth required |
| Policy | Effective | Status of 77522 |
|---|---|---|
| Proton Beam, Neutron Beam and Carbon Ion Radiation Therapy | Mar 2, 2026 | Covered |
| Policy | Effective | Status of 77522 |
|---|---|---|
| Charged-Particle (Proton) Radiotherapy | Oct 1, 2025 | Covered |
| Policy | Effective | Status of 77522 |
|---|---|---|
| Radiation and Oncologic Procedures | Not recorded | Covered |