`G0251` Linear acc based stero radio

Linear accelerator based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, maximum five sessions per course of treatment

Medicare coverage: Special coverage instructions apply
Status: terminated 20141231

Payer policies and prior authorization for G0251

Payer coverage policies that name G0251

G0251 appears in 1 coverage policy from Aetna.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Trigeminal Neuralgia: Treatments (0374)	covered if criteria are met	Jun 29, 2026	payer document

Medicaid fee-for-service

WY: $0.00 (professional), effective Jan 1, 2015

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.

G0251 Linear acc based stero radio

Payer policies and prior authorization for G0251

Payer coverage policies that name G0251

Medicaid fee-for-service

`G0251` Linear acc based stero radio