G6012, Radiation treatment delivery, 3 or more separate treatment areas, custom
HCPCS/CPT
Prior Authorization
Prior Auth Required
Code explicitly requires prior authorization (high confidence)
Documentation Required
- Documentation may be required to support a service request and must reflect the clinical situation at the time and document the ordering provider’s clinical intent.
2 Active Policies
EVICORE-HPLAN-HEALTH_PARTNERS_PLANS-0414D494E567, Health Partners Plans Radiation Therapy Code List - Effective 01/01/2025
CARELON-radiation-therapy-excludes-proton-2026-04-04, Radiation Therapy Excludes Proton
Related Codes
Have a follow-up question?
Ask Verity about documentation requirements, denial risks, or coverage in your state.