New simplified radiation therapy prior authorizations
In response to recent changes by the American Medical Association (AMA) and the Centers for Medicare and Medicaid Services (CMS), beginning Jan. 1, 2026, we’re updating prior authorization requirements for certain radiology oncology CPT® and HCPCS codes.
This applies to UnitedHealthcare® Medicare Advantage Plans, UnitedHealthcare Community Plans, UnitedHealthcare commercial plans and UnitedHealthcare Individual Exchange plans.
Patients currently receiving radiation therapy
If prior authorization for IMRT, IGRT or Standard Radiation Therapy (2D/3D) was approved for treatment starting before Jan. 1, 2026, no new prior authorization request is needed. We’re working on a “grandfathering” effort to update all approved authorization for the termed IMRT, IGRT and Standard Radiation Therapy 2D/3D procedure codes with the updated radiation therapy procedure codes.
Patients needing radiation therapy on or after Jan. 1
For treatments starting on or after Jan. 1, 2026, submit prior authorization requests using the new AMA/CMS procedure codes for IMRT, IGRT and Standard Radiation Therapy (2D/3D) radiation therapy services.
On Jan. 1, 2026, the following codes will no longer require prior authorization:
| Procedure code | Description |
|---|---|
| 77385, 77386, G6015 and G6016 | Intensity Modulated Radiation Therapy (IMRT) |
| 77014, G6001, G6002 and G6017 | Image Guided Radiation Therapy (IGRT) |
| 77401, G6003, G6004, G6005, G6006, G6007, G6008, G6009, G6010, G6011, G6012, G6013 and G6014 | Standard Radiation Therapy (2D/3D) |
On Jan. 1, 2026, the following procedure codes should be used for prior authorization when treating for oncologic and hematologic diagnoses:
| Procedure code | Description | Changes |
|---|---|---|
| 77402 | Radiation treatment delivery; Level 1 (e.g., single-electron field, multiple-electron fields, or 2D photons), including imaging guidance, when performed | Revised to consolidate and more clearly specify services provided for radiation treatment delivery |
| 77407 | Radiation treatment delivery; Level 2, single-isocenter (e.g., 3D or IMRT), photons, including imaging guidance, when performed | |
| 77412 | Radiation treatment delivery; Level 3, multiple isocenters with photon therapy (e.g., 2D, 3D or IMRT) or a single-isocenter photon therapy (e.g., 3D or IMRT) with active motion management, or total skin electrons or mixed-electron/photon field(s), including imaging guidance, when performed | |
| 77387-26 | Image Guided Radiation Therapy (IGRT) | Repurposed to capture the professional component (PC) of image guidance, while its technical component (TC) and associated codes (like 77014) get bundled into revised treatment delivery codes (77407, 77412) |
You can review the coverage determination guidelines we use to facilitate our determinations for the radiation therapy services.
How to submit and manage prior authorizations
- Sign in to the UnitedHealthcare Provider Portal with your One Healthcare ID
- If you don’t have a One Healthcare ID, register now
- From the left-hand tabs, select Prior Authorizations & Notifications
Questions? We’re here to help.
If you have questions, email unitedoncology@uhc.com.
CPT® is a registered trademark of the American Medical Association.
PCA-1-25-02753-Corp-NN_12222025
