Radiation Therapy Billing Update for 2026

The Centers for Medicare & Medicaid Services (CMS) updated radiation therapy codes to a new complexity-based code structure. As of January 1, billing now reflects clinical complexity, not technique. Factors include isocenters and motion management.

What’s New

• The Centers for Medicare & Medicaid Services retired current procedural terminology (CPT) codes 77014, 77385, 77386, and healthcare common procedure coding system (HCPCS) codes G6003–G6017.
• All external beam radiation therapy (EBRT) services should be billed using 77402, 77407, or 77412.
• Image‑guided radiation therapy (IGRT) is now streamlined as the technical component. It’s bundled into primary delivery codes. The professional component should be billed separately using 77387‑26.
• 2D/3D conformal authorizations issued in 2025 already included new codes. Most providers will see minimal impact.
• No new prior authorizations are needed. Carelon Medical Benefit Management will map codes to keep authorizations and claims processing smoothly.

Radiation oncology services are managed by Carelon Medical Benefit Management. Reference their radiation oncology guidelines. Questions about the guidelines? Email Carelon at medicalbenefitsmanagement.guidelines@carelon.com.