Summary & Overview
HCPCS G6004: Radiation Treatment Delivery, 6–10 MeV, Single Port or Parallel Opposed Ports
HCPCS Level II code G6004 denotes delivery of external beam radiation therapy to a single treatment area using a single port or parallel opposed ports with simple blocks or no blocks at beam energies of 6–10 MeV. This distinction matters nationally for billing, clinical documentation, and distinguishing simple therapy techniques from more complex radiation delivery codes. Accurate use of G6004 affects claim processing and appropriate classification of radiation therapy encounters.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of how the code is defined, the clinical context for use in radiation oncology, and where the service is typically provided. The publication outlines common modifiers associated with radiation therapy billing (listed separately), potential coding pitfalls, and how G6004 relates to treatment complexity and service categorization.
The report provides benchmarks and comparative policy notes relevant to national payers, clarifies the service line placement for outpatient radiation therapy, and summarizes expected documentation elements tied to this simple external beam treatment. Data not available in the input for payer-specific rates, taxonomies, ICD-10 pairings, and related codes is identified where applicable.
Billing Code Overview
HCPCS Level II code G6004 describes radiation treatment delivery for a single treatment area using a single port or parallel opposed ports with simple blocks or no blocks at beam energies of 6–10 MeV. The service type is external beam radiation therapy (simple technique) delivered in a single treatment field. The typical site of service is an outpatient radiation oncology department, freestanding radiation therapy center, or hospital outpatient clinic where external beam therapy is administered.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with a newly diagnosed localized squamous cell carcinoma of the skin on the forehead is referred to radiation oncology for definitive local control. The treatment plan documents a single treatment area to be treated with a single port using a 6–10 megavolt (MeV) linear accelerator beam. The simulation visit includes immobilization, surface marking, and simple custom shielding (or no shielding) as appropriate. On treatment day the radiation therapist verifies setup and portal images as needed, delivers a single-field external beam fraction (palliative or definitive single-field session), and documents machine parameters and patient tolerance in the treatment record. Typical workflow steps: patient consult and staging, simulation and treatment planning (physician-approved simple plan for a single port), daily setup verification, delivery of the single-field radiation treatment, and post-treatment documentation and follow-up. Typical site of service is an outpatient radiation oncology department or freestanding radiation therapy center. The service is commonly used for simple single-field treatments such as small superficial tumors, palliative single-fraction treatments, or boost treatments where only one port or parallel opposed ports are used with simple or no blocks.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Professional component | When billing only the physician professional component separate from technical services, if applicable to a billable professional service tied to the delivery. |