UnitedHealthcare · PayerPolicy · UHC-POL-stereotactic-body-radiation-therapy-radiosurgery
Summary of the payer’s published policy. Not a coverage determination — confirm with UnitedHealthcare before submitting.
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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.
| Code | Code system | Status in this policy |
|---|---|---|
| 32701 | CPT | Covered |
| 61796 | CPT | Covered |
| 61797 | CPT | Covered |
| 61798 | CPT | Covered |
| 61799 | CPT | Covered |
| 61800 | CPT | Covered |
| 63620 | CPT | Covered |
| 63621 | CPT | Covered |
| 77301 | CPT | Covered |
| 77371 | CPT | Covered |
| 77372 | CPT | Covered |
| 77373 | CPT | Covered |
| 77432 | CPT | Covered |
| 77435 | CPT | Covered |
| G0339 |
|---|
| HCPCS |
| Covered |
| G0340 | HCPCS | Covered |
|---|
| G0563 | HCPCS | Covered |
|---|