CurrentMolina HealthcarePolicy N/A

Image-guided radiation therapy (IGRT) reimbursement

Governs Molina Healthcare reimbursement and coding guidance for professional and technical components of image-guided radiation therapy (IGRT) for affected providers and billing staff; state exceptions may apply.

Policy Summary

PayerMolina Healthcare

PolicyImage-guided radiation therapy (IGRT) reimbursement

Policy CodePolicy N/A

Change TypeNo material changes

Effective Date

Next Review Date

Key ActionUse codes G6001, G6002, G6017, or 77014 for the professional component of IGRT and append modifier -26 when billing the professional component except for G6017.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

4IGRT/procedure codes referenced

1Policy purpose

CMSPrimary external reference

Bundled77387 treatment status

IGRT Coverage and Reimbursement Stance

IGRT coverage criteria

Policy Summary

PayerMolina Healthcare

PolicyImage-guided radiation therapy (IGRT) reimbursement

Policy CodePolicy N/A

Change TypeNo material changes

Effective Date

Next Review Date

Key ActionUse codes G6001, G6002, G6017, or 77014 for the professional component of IGRT and append modifier -26 when billing the professional component except for G6017.

SourceLink

On This Page

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Professional component of IGRT may be reported in addition to IMRT when using specified codes (G6001, G6002, G6017, 77014); append modifier -26 for professional component billing except G6017 which is professional-only.

Technical component of IGRT is bundled into IMRT (not separately reimbursed) for IMRT delivery; for conventional radiation delivery, IGRT may be reported for both professional and technical components.

Code 77387 is not considered valid for Medicare professional services per CMS and is bundled into IMRT under federal Medicaid NCCI rules; reimbursement for 77387 is not provided according to CMS guidelines.

Note: State exceptions may apply; refer to state exception table in the policy and applicable benefit documents or contracts for final determination.

Procedure Codes, Modifiers, and Billing Guidance

IGRT procedure codesCPT

77387	Guidance for localization of target volume for delivery of radiation treatment, includes intrafraction tracking, when performed.
77014	Computed tomography guidance for placement of radiation therapy fields.
G6001	Ultrasonic guidance for placement of radiation therapy fields.
G6002	Stereoscopic x-ray guidance for localization of target volume for the delivery of radiation therapy.
G6017	Intra-fraction localization and tracking of target or patient motion during delivery of radiation therapy (e.g., 3D positional tracking, gating, 3D surface tracking), each fraction of treatment.

Covered/Not Covered Notes (policy guidance)mixed

No codes listed

Modifier -26 usage — IGRT professional component

Modifier -26 requirementAppend modifier -26 to IGRT codes when billing the professional component (applies to G6001, G6002, and 77014).

Exception — G6017Do not append modifier -26 to G6017; G6017 pertains exclusively to professional services and cannot be billed with modifier -26.

Codes impactedThis modifier guidance applies to G6001, G6002, G6017, and 77014 as the IGRT professional component codes referenced in the policy.

Billing practice noteWhen submitting claims for the professional component of IGRT, ensure the -26 modifier is used on the applicable codes to distinguish professional from technical components, except where explicitly excluded (G6017).

Billing, Prior Authorization, and Provider Responsibilities

Billing Rule

Billing and prior authorization: IGRT professional component coding and modifier rules

Use CPT/HCPCS G6001, G6002, G6017, or 77014 to report the professional component of IGRT. Append modifier -26 when billing the professional component for these codes, except G6017 which is professional-only and must not be billed with modifier -26. Note that code 77387 is not valid for Medicare professional reimbursement per CMS and is bundled into IMRT under federal Medicaid NCCI rules.

Bill professional component with G6001, G6002, G6017, or 77014 as appropriate to the method used.
Append modifier -26 for professional component billing for these codes except do not append -26 to G6017.
Do not use 77387 for Medicare professional services; 77387 is bundled into IMRT per federal Medicaid NCCI rules.

OpenPayer

Image-guided radiation therapy (IGRT) reimbursement

IGRT Coverage and Reimbursement Stance

Procedure Codes, Modifiers, and Billing Guidance

Billing, Prior Authorization, and Provider Responsibilities

Referenced Agencies and Definitions