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CommercialPrior AuthHigh impact

25-1121 Radiation Oncology Code Updates, Effective January 1, 2026

Health Net·CA · Oncology, Radiology·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Days to comply

Summary

Starting January 1, 2026, Health Net will require prior authorization for new radiation oncology CPT codes 77X05, 77X07, 77X08, and 77X09, while removing prior auth requirements for codes 77750, 79403, A9543, and A9590. Additionally, 17 obsolete radiation oncology codes are being deleted entirely and can no longer be billed.

Action Required

Action needed
By January 1, 2026: Billing team must update system to require prior authorization for new CPT codes 77X05, 77X07, 77X08, and 77X09 through EviCore (online or 888-693-3211). Remove prior auth requirements for codes 77750, 79403, A9543, and A9590. Delete 17 obsolete codes from billing system (77385, 77386, 77401, 0394T, G6001-G6017) as they can no longer be billed. Update encounter forms and notify radiation oncology providers of these changes.

Affected Billing Codes

77750
79403
A9543
A9590
77385
77386
77401
G6001
G6002
G6003
G6004
G6005
G6006
G6007
G6008
G6009
G6010
G6011
G6012
G6013
G6014
G6015
G6016
G6017