Radiation Therapy Management - CPT code 77427
This Humana claims payment policy describes billing and reimbursement requirements for CPT code 77427 (radiation treatment management, 5 treatments) for Medicare Advantage and Commercial products and informs providers how to submit units, session counts, and service dates.
No material clinical or coverage changes in this revision.
Payment and Billing Criteria for CPT 77427
CPT 77427 payment criteria
Billing and payment criteria for CPT code 77427
End-of-course exception
- Provider may submit a three- or four-session unit only at the end of a course of treatment; that unit must be submitted as a single-unit charge distinct from all other units.
- Humana denies charges at the end of a course of treatment for fewer than three sessions.
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