MedicaidCoverageHigh impact
Electric Tumor Treatment Field Therapy (for North Carolina Only)
UnitedHealthcare·NC · Oncology, Radiation Oncology·Medical Policy
Effective date
Oct 1, 2026
We identified it
Oct 3, 2026
Summary
UnitedHealthcare Community Plan of North Carolina has updated its policy on Electric Tumor Treatment Field Therapy, adding notation that HCPCS codes A4555, E0766, and E0767 are NOT on the North Carolina Medicaid Fee Schedule and therefore may not be covered by NC Medicaid. The policy also updated clinical evidence and references to reflect current information, effective October 1, 2026.
Action Required
By October 1, 2026: Billing team must update billing system and claim submission protocols to flag HCPCS codes A4555, E0766, and E0767 as non-covered under North Carolina Medicaid. Before submitting claims for Electric Tumor Treatment Field Therapy equipment/supplies using these codes for NC Medicaid patients, verify coverage with UnitedHealthcare Community Plan and obtain prior authorization if available. Update encounter forms and clinical staff documentation templates to alert providers that these specific codes may require alternative coding or that claims may be denied. Do not bill these codes to NC Medicaid without explicit pre-authorization. Implement internal tracking to monitor claim denials related to these codes and communicate findings to providers.