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PAYER POLICY CHANGES

77435 Insurance Policy Changes

CPT 77435, in plain terms, covers Physician management of a full stereotactic body radiation course outside the brain delivered in 5 or fewer sessions, billed once per course and apart from planning and delivery. CPT 77435 is referenced in 7 tracked payer policy changes from Harvard Pilgrim Health Care, Independence Blue Cross, and 3 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 77435 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 77435 on AAPC

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REFERENCE DATA

Payers with rules17
Payers requiring prior auth17
  • Anthem BCBS · Effective November 1, 2026

    Prior authorization required

    Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial)

  • BCBS Michigan · Effective October 13, 2026

    Prior authorization required in some cases

    BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines)

  • BCBS Illinois · Effective October 1, 2026

    Prior authorization required in some cases

    Blue Cross Community Health Plans (Illinois Medicaid) Prior Authorization Code List

FREQUENTLY ASKED QUESTIONS

Does Ambetter require prior authorization for 77435?

Ambetter lists 77435 on Ambetter from Arizona Complete Health CMS-0057-F prior authorization requirements for exchange plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Anthem BCBS require prior authorization for 77435?

Anthem BCBS lists 77435 on Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial) for commercial plans (list dated November 1, 2026). Verify with the payer before scheduling.

Does Arizona Complete Health require prior authorization for 77435?

Arizona Complete Health lists 77435 on Arizona Complete Health CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does BCBS Illinois require prior authorization for 77435?

BCBS Illinois lists 77435 on 2026 Commercial Outpatient Medical Surgical Prior Authorization Codes for commercial plans, with conditions (list dated January 1, 2026). Verify with the payer before scheduling.

Does BCBS Michigan require prior authorization for 77435?

BCBS Michigan lists 77435 on BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines) for commercial plans (list dated October 13, 2026). Verify with the payer before scheduling.

What insurance policy changes affect CPT 77435?

There are 7 tracked policy changes affecting CPT 77435, including updates from Harvard Pilgrim Health Care, Independence Blue Cross, Blue Cross Blue Shield of Rhode Island. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 77435?

Payers that have issued tracked updates for CPT 77435 include: Harvard Pilgrim Health Care, Independence Blue Cross, Blue Cross Blue Shield of Rhode Island, Excellus BlueCross BlueShield, Aetna.

How do I get notified when CPT 77435 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 77435. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for CPT 77435?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

See every payer rule for 77435

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 77435 in one place.

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