New streamlined radiation therapy prior authorization updates
AI Summary
UnitedHealthcare is streamlining radiation therapy prior authorization requirements effective January 1, 2026. Multiple existing codes for IMRT, IGRT, and Standard Radiation Therapy will no longer require prior authorization, while new consolidated codes (77402, 77407, 77412, 77387-26) will be used for prior authorization requests for treatments starting on or after that date.
Action Required
By January 1, 2026: Billing team must update prior authorization workflows to remove prior auth requirements for codes 77385, 77386, G6015, G6016, 77014, G6001, G6002, G6017, 77401, G6003-G6014. Begin using new codes 77402, 77407, 77412, and 77387-26 for prior authorization requests for radiation therapy treatments starting on or after January 1, 2026. Update billing software rules and notify radiation oncology providers of the code changes. Review existing approved authorizations as UnitedHealthcare will automatically update them with new procedure codes.
Affected Billing Codes
Plan Types
Medicare Advantage, Medicaid, Commercial, Exchange
Specialties
oncology, radiology