25-1395 Radiation Oncology Code Update - Finalized Codes Effective January 1, 2026
Date: 12/30/25
Final CPT codes assigned to previous placeholders
This update corrects provider communication, 25-1121, Radiation Oncology Code Updates, Effective January 1, 2026, distributed on October 24, 2025. To view details of this communication, search Provider Updates and Notices in the Provider Library under HMO or PPO.
The Centers for Medicare & Medicaid Services (CMS) has finalized the placeholder codes shared in the previous communication.
Key changes
- Placeholder codes now have final CPT codes assigned.
- Prior authorization (PA) requirements remain in effect for
these codes.
Finalized CPT codes
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New CPT code | Previous placeholder | Prior authorization rule |
|---|---|---|
77437 | 77X07 | Prior authorization required |
77438 | 77X08 | Prior authorization required |
77439 | 77X09 | Prior authorization required |
Deleted code
The following code has been added to the deleted codes list shared previously.
CPT code | Prior authorization rule |
|---|---|
77014 | Deleted |
Prior authorization requests
EviCore will continue to manage prior authorization for radiation therapy for Health Net HMO and PPO members. Physicians and other providers must submit requests for newly introduced codes starting January 1, 2026.
Submit requests via:
- Online: EviCore
- Phone: 888-693-3211
Need help? Contact us
If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center by email, by phone or through the Health Net provider portal.
Provider Services
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.