25-1121 Radiation Oncology Code Updates, Effective January 1, 2026
Date: 10/24/25
What’s changing and why it matters
Beginning January 1, 2026, updates to CPT/HCPCS radiation oncology codes requiring prior authorization will go into effect. These changes are designed to align coding practices with current clinical standards, streamline prior authorization processes and remove outdated procedures.
Key highlights
- Revised CPT codes requiring authorization to reflect updated clinical practices.
- Deletion of obsolete codes.
These updates are part of the Centers for Medicare & Medicaid Services (CMS) and EviCore Healthcare’s (EviCore’s) ongoing efforts to improve accuracy, reduce administrative burden and phase out low-utilization treatments, including those impacted by discontinued isotope production.
Prior authorization requests
EviCore will continue to manage prior authorization process for radiation therapy for Health Net* HMO and PPO members. Providers must submit requests for newly introduced codes starting January 1, 2026.
Submit requests via:
- Online: EviCore
- Phone: 888-693-3211
Managed code list updates and changes
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New codes requiring PA:
CPT Codes | PA Rule |
|---|---|
77X05 | PA required |
77X07 | PA required |
77X08 | PA required |
77X09 | PA required |
No PA required:
CPT/HCPCS Codes | PA Rule |
|---|---|
77750 | No PA required |
79403 | No PA required |
A9543 | No PA required |
A9590 | No PA required |
Deleted codes:
CPT/HCPCS Codes | PA Rule |
|---|---|
77385 | Deleted |
77386 | Deleted |
77401 | Deleted |
0394T | Deleted |
G6001 | Deleted |
G6002 | Deleted |
G6003 | Deleted |
G6004 | Deleted |
G6005 | Deleted |
G6006 | Deleted |
G6007 | Deleted |
G6008 | Deleted |
G6009 | Deleted |
G6010 | Deleted |
G6011 | Deleted |
G6012 | Deleted |
G6013 | Deleted |
G6014 | Deleted |
G6015 | Deleted |
G6016 | Deleted |
G6017 | Deleted |
Additional information
If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center by email, by telephone or through the Health Net provider portal.
Line of business | Phone number | |
|---|---|---|
Ambetter from Health Net IFP Ambetter PPO | ||
Ambetter HMO | ||
Health Net Employer Group HMO, POS, & PPO |
This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, and Ancillary Providers.