10 commercial payer policies list 77767. 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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10 policies from 7 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 77767 |
|---|---|---|
| Aetna Radiation Oncology Code List | Jan 1, 2026 | Prior auth required |
| Radiation Treatment for Selected Nononcologic Indications | Jul 27, 2023 | Covered |
| Policy | Effective | Status of 77767 |
|---|---|---|
| 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 77767 |
|---|---|---|
| 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 77767 |
|---|---|---|
| Radiation Therapy (excludes Proton) | Apr 4, 2026 | Covered |
| Policy | Effective | Status of 77767 |
|---|---|---|
| GHI/Emblem Non-City of New York & Medicare Radiation Oncology Code List | Jan 1, 2026 | Prior auth required |
| Policy | Effective | Status of 77767 |
|---|---|---|
| eviCore Radiation Oncology Coding Guidelines | Jan 1, 2021 | Covered with conditions |
| Policy | Effective | Status of 77767 |
|---|---|---|
| Health Partners Plans Radiation Therapy Code List | Jan 1, 2025 | Prior auth required |