Radiation Therapy Management Program — precertification and code changes
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Defines precertification requirements and lists CPT/HCPCS code additions and deletions for radiation therapy services affecting Blue Cross Blue Shield - Alabama members and providers.
Several radiation therapy CPT/HCPCS codes (including 77437, 77438, 77439 and G6010-G6017) were added effective January 1, 2026.
G0563 was added with an effective date of January 1, 2025.
Multiple codes (including 77014, 77385, 77401, 77750 and others) were deleted effective December 31, 2025.
Precertification effective dates for numerous RT procedure codes are provided or updated, including several set to January 1, 2026.
Radiation Therapy Coverage Criteria
Radiation Therapy precertification and code update rules
Precertification is required for specified radiation therapy CPT/HCPCS codes; the policy also lists code additions and deletions with effective dates.
ALL of the following
- Listed RT codes requiring precertification: Precertification is required for the radiation therapy CPT/HCPCS codes listed in the policy; effective dates for precertification are provided per code (examples: 77437, 77438, 77439 — PRECERTIFICATION effective date January 1, 2026; multiple legacy codes with earlier effective dates such as 77371–77373, 77387, 77402, 77407, 77412, 77423–77425, 77520, 77522 are noted).
Providers must obtain prior authorization for the codes marked PRECERTIFICATION per the effective dates in the policy.
ALL of the following
- Added effective January 1, 2025: G0563 (Code Addition Effective January 1, 2025).
ALL of the following
ALL of the following
- Codes listed with the PRECERTIFICATION flag require prior authorization as indicated in the policy; providers should reference the documented effective dates when submitting authorization requests.
CPT/HCPCS Code Additions, Deletions, and Flags
| 77437 | 77437 |
| 77438 | 77438 |
| 77439 | 77439 |
| G6010 | G6010 |
| G6011 | G6011 |
| G6012 | G6012 |
| G6013 | G6013 |
| G6014 | G6014 |
| G6015 | G6015 |
| G6016 | G6016 |
| G0563 | G0563 |
Precertification and Provider Requirements
Precertification required for listed RT CPT/HCPCS codes
Precertification is required for all listed radiation therapy CPT and HCPCS procedure codes. The policy lists each code with a “PRECERTIFICATION EFFECTIVE DATE” (for example, 77437–77439 are noted as PRECERTIFICATION with effective date January 1, 2026; G0563 is noted with effective date January 1, 2025). Providers must obtain prior authorization per these precertification designations before billing or delivering the services.
Terminology
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