Radiation Therapies
JJ · Effective Dec 3, 2023
6 active Medicare policies list G0339, 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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JJ · Effective Dec 3, 2023
JM · Effective Dec 3, 2023
J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
National · Effective Apr 1, 2026
J6 · Effective Jan 1, 2025
19 policies from 12 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of G0339 |
|---|---|---|
| Aetna Radiation Oncology Code List - Effective 01/01/2026 | Jan 1, 2026 | Prior auth required |
| Headaches: Invasive Procedures | Feb 20, 2024 | Covered |
| Stereotactic Radiosurgery | Feb 8, 2023 | Covered |
| Policy | Effective | Status of G0339 |
|---|---|---|
| Charged-Particle (Proton) Radiotherapy | Oct 1, 2025 | 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 G0339 |
|---|---|---|
| Radiation Therapy Excludes Proton | Not recorded | Covered |
| Radiation Therapy for Non Malignant Disease | Not recorded | Covered |
| Policy | Effective | Status of G0339 |
|---|---|---|
| Cigna Commercial Radiation Oncology Code List - Effective 03/07/2026 | Mar 7, 2026 | Prior auth required |
| Cigna Comprehensive Code List - Effective 03/07/2026 | Mar 7, 2026 | Prior auth required |
| Policy | Effective | Status of G0339 |
|---|---|---|
| Cigna Commercial & Medicare Advantage Radiation Oncology Code List - Effective 01/01/2026 | Jan 1, 2026 | Prior auth required |
| Cigna OBM Radiation Oncology Code List - Effective 01/01/2026 | Jan 1, 2026 | Prior auth required |
| Policy | Effective | Status of G0339 |
|---|---|---|
| Stereotactic Body Radiation Therapy | Not recorded | Covered |
| Policy | Effective | Status of G0339 |
|---|---|---|
| GHI/Emblem Non-City of New York & Medicare Radiation Oncology Code List - Effective 01/01/2026 | Jan 1, 2026 | Prior auth required |
| Policy | Effective | Status of G0339 |
|---|---|---|
| Health Partners Plans Radiation Therapy Code List - Effective 01/01/2025 | Jan 1, 2025 | Prior auth required |
| Policy | Effective | Status of G0339 |
|---|---|---|
| Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery | Oct 1, 2026 | Covered |
| Policy | Effective | Status of G0339 |
|---|---|---|
| Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery | Oct 1, 2026 | Covered |
| Policy | Effective | Status of G0339 |
|---|---|---|
| Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery | Oct 1, 2026 | Covered |
| Policy | Effective | Status of G0339 |
|---|---|---|
| Radiation and Oncologic Procedures | Not recorded | Covered |