77338 CPT® code: payer coverage and prior authorization19 of 26 payer prior-auth lists that name 77338 require prior authorization or set conditions: Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Texas, CarePlus Health Plans, Cigna, HealthSpring, Humana, Molina Healthcare of California, Molina Healthcare of Illinois, Molina Healthcare of Michigan.
77338 appears in 55 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, BlueCross BlueShield of South Carolina, Centene, Regence, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Cemiplimab-rwlc (Libtayo) (0942) | listed, no stance (range 77261-77799) | Jun 12, 2026 | payer document |
| Aetna | Growth Hormone (GH) and Growth Hormone Antagonists (0170) | listed, no stance (range 77261-77799) | Jun 26, 2026 | payer document |
| Aetna | Hematopoietic Cell Transplantation for Selected Childhood Solid Tumors (0496) | listed, no stance (range 77261-77799) | Aug 6, 2026 | payer document |
| Aetna | Infertility (0327) | listed, no stance (range 77261-77790) | Jul 16, 2026 | payer document |
| Aetna | Intensity Modulated Radiation Therapy (0590) | covered if criteria are met | Sep 8, 2026 | payer document |
| Aetna | Intraoperative Radiation Therapy (IORT) (0721) | listed, no stance (range 77300-77399) | Oct 20, 2025 | payer document |
| Aetna | Strontium Chloride Sr-89 (0361) | listed, no stance (range 77261-77525) | Jan 9, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Intensitymodulated Radiotherapy Imrt Abdomen Pelvis And Chest | covered if criteria are met | payer document | |
| Blue Cross & Blue Shield of Mississippi | Intensitymodulated Radiotherapy Imrt Breast And Lung | covered if criteria are met | payer document | |
| Blue Cross & Blue Shield of Mississippi | Intensitymodulated Radiotherapy Imrt Cancer Of The Head And Neck Or Thyroid | covered if criteria are met | payer document | |
| Blue Cross & Blue Shield of Mississippi | Intensitymodulated Radiotherapy Imrt Central Nervous System Tumors (L.8.01.416) | covered if criteria are met | payer document | |
| Blue Cross & Blue Shield of Mississippi | Intensitymodulated Radiotherapy Imrt Prostate (L.8.01.415) | covered if criteria are met | payer document | |
| Blue Cross NC | Intensity Modulated Radiation Therapy (IMRT) for Sarcoma of the Extremities | listed, no stance | May 1, 2026 | payer document |
| Blue Cross NC | Intensity Modulated Radiation Therapy (IMRT) of Abdomen and Pelvis | listed, no stance | May 1, 2026 | payer document |
| Blue Cross NC | Intensity Modulated Radiation Therapy (IMRT) of Head and Neck | listed, no stance | May 1, 2026 | payer document |
| Blue Cross NC | Intensity Modulated Radiation Therapy (IMRT) of the Chest | listed, no stance | May 1, 2026 | payer document |
| Blue Cross NC | Intensity Modulated Radiation Therapy (IMRT) of the Prostate | listed, no stance | May 1, 2026 | payer document |
| Blue Cross NC | Intensity Modulated Radiation Therapy for Tumors of the Central Nervous System | listed, no stance | May 1, 2026 | payer document |
| Blue Cross NC | Radiation Therapy Services | listed, no stance | Nov 1, 2025 | payer document |
| Blue Cross NC | Radiosurgery, Stereotactic Approach | listed, no stance | May 1, 2026 | payer document |
| BlueCross BlueShield of South Carolina | Breast Cancer Radiation Oncology (CAM 381) | listed, no stance | Apr 1, 2026 | payer document |
| BlueCross BlueShield of South Carolina | Intensity-Modulated Radiotherapy of the Lung (CAM 80146) | listed, no stance | Apr 1, 2026 | payer document |
| BlueCross BlueShield of South Carolina | Intensity-Modulated Radiotherapy of the Prostate (CAM 80147) | listed, no stance | Aug 1, 2026 | payer document |
| BlueCross BlueShield of South Carolina | Intensity-Modulated Radiotherapy: Cancer of the Head and Neck or Thyroid (CAM 80148) | listed, no stance | Aug 1, 2026 | payer document |
| Centene | Intensity-Modulated Radiotherapy (CP.MP.69) | covered if criteria are met | Feb 1, 2025 | payer document |
| Regence | Charged-Particle (Proton) Radiotherapy (Medicine 49) | listed, no stance | Aug 1, 2025 | payer document |
| Regence | Intensity Modulated Radiotherapy (IMRT) for Breast Cancer (Medicine 166) | listed, no stance | Dec 1, 2025 | payer document |
| Regence | Intensity Modulated Radiotherapy (IMRT) for Tumors in Close Proximity to Organs at Risk (Medicine 167) | listed, no stance | Dec 1, 2025 | payer document |
| Regence | Intensity Modulated Radiotherapy (IMRT) of the Central Nervous System (CNS), Head, Neck, and Thyroid (Medicine 164) | listed, no stance | Dec 1, 2025 | payer document |
| Regence | Intensity Modulated Radiotherapy (IMRT) of the Thorax, Abdomen, Pelvis, and Extremities (Medicine 165) | listed, no stance | Dec 1, 2025 | payer document |
| Regence | Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy for Tumors Outside of Intracranial, Skull Base, or Orbital Sites (Surgery 214) | listed, no stance | Sep 1, 2025 | payer document |
| Regence | Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy of Intracranial, Skull Base, and Orbital Sites (Surgery 213) | listed, no stance | Sep 1, 2025 | payer document |
| UnitedHealthcare | Intensity-Modulated Radiation Therapy (2026T0407HH) | listed, no stance | Mar 1, 2026 | payer document |
| UnitedHealthcare | Intensity-Modulated Radiation Therapy (CS064.T) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Intensity-Modulated Radiation Therapy (for Idaho Only) (CS064ID.C) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Intensity-Modulated Radiation Therapy (for Kansas Only) (CS064KS.02) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Intensity-Modulated Radiation Therapy (for Kentucky Only) (CS064KY.09) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Intensity-Modulated Radiation Therapy (for Nebraska Only) (CS064NE.T) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Intensity-Modulated Radiation Therapy (for New Jersey Only) (CS064NJ.Q) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Intensity-Modulated Radiation Therapy (for New Mexico Only) (CS064NM.C) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Intensity-Modulated Radiation Therapy (for North Carolina Only) (CSNCT0407.05) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Intensity-Modulated Radiation Therapy (for Ohio Only) (CS064OH.D) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Intensity-Modulated Radiation Therapy (for Pennsylvania Only) (CS064PA.S) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Intensity-Modulated Radiation Therapy (for Tennessee Only) (CS064TN.S) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Proton Beam Radiation Therapy (CS105.U) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Proton Beam Radiation Therapy (2026T0132MM) | listed, no stance | Mar 1, 2026 | payer document |
| UnitedHealthcare | Proton Beam Radiation Therapy (for Idaho Only) (CS105ID.C) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Proton Beam Radiation Therapy (for Kansas Only) (CS105KS.03) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Proton Beam Radiation Therapy (for Kentucky Only) (CS105KY.11) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Proton Beam Radiation Therapy (for Nebraska Only) (CS105NE.U) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Proton Beam Radiation Therapy (for New Jersey Only) (CS105NJ.R) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Proton Beam Radiation Therapy (for New Mexico Only) (CS105NM.D) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Proton Beam Radiation Therapy (for Ohio Only) (CS105OH.E) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Proton Beam Radiation Therapy (for Pennsylvania Only) (CS105PA.U) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Proton Beam Radiation Therapy (for Tennessee Only) (CS105TN.T) | listed, no stance | May 1, 2026 | payer document |
Prior authorization required or conditional in WA.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.