Intensity Modulated Radiation Therapy | Humana | Backwork

Intensity Modulated Radiation Therapy

Humana · PayerPolicy · HUMANA-INTENSITY-MODULATED-RADIATION-THERAPY-MA

Status: Active
Effective: March 2, 2026
Last reviewed by Humana: February 10, 2026
Last checked by Backwork: September 30, 2026

Summary of the payer’s published policy. Not a coverage determination — confirm with Humana before submitting.

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Codes in this policy

Each code’s status is what the policy records for it. This page does not show the policy’s criteria. Read them in the payer’s source.

Codes this policy lists and each code’s status in the policy
Code	Code system	Status in this policy
51721	CPT	Covered
55874	CPT	Covered
55876	CPT	Covered
55881	CPT	Covered
55882	CPT	Covered
77280	CPT	Covered
77290	CPT	Covered
77295	CPT	Covered
77301	CPT	Covered
77338	CPT	Covered
77385	CPT	Covered
77386	CPT	Covered