What insurance policy changes affect CPT 77437?

There are 15 tracked policy changes affecting CPT 77437, including updates from Anthem BCBS, Humana, CareSource. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 77437?

Payers that have issued tracked updates for CPT 77437 include: Anthem BCBS, Humana, CareSource, Blue Cross Blue Shield of Massachusetts, Highmark, BlueCross BlueShield of South Carolina, Blue Cross NC, Blue Cross & Blue Shield of Mississippi, Health Net.

How do I get notified when CPT 77437 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 77437. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 77437?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

77437 Insurance Policy Changes

CPT 77437 is referenced in 15 tracked payer policy changes from Anthem BCBS, Humana, and 7 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 77437 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Medium impact
[Ohio] Prior authorization requirement updates — Carelon Medical Benefits Management
Anthem BCBS·Effective Oct 1, 2026
Effective October 1, 2026, Carelon Medical Benefits Management is adding four radiation oncology CPT codes (77436, 77437, 77438, 77439) to their prior authorization requirement list for commercial plans in Ohio. Billing teams must begin obtaining precertification for these surface radiation therapy procedures through Carelon's provider portal or Availity before claims are submitted.
High impact
Superficial Radiation Therapy - Medicare Advantage (Revised)
Humana·Effective Aug 3, 2026
Humana Medicare Advantage has updated its Superficial Radiation Therapy (SRT) policy effective 08/03/2026, establishing coverage criteria for nonmelanoma skin cancer treatment and introducing four new CPT codes (77436, 77437, 77438, 77439) effective 01/01/2026. The policy covers SRT including electronic brachytherapy and image-guided SRT when medical necessity criteria from applicable Local Coverage Determinations are met, with coverage varying by Medicare Administrative Contractor jurisdiction.
High impact
[Georgia] Prior Authorization Requirement Update
CareSource·Effective Aug 1, 2026
CareSource Georgia Medicaid is requiring prior authorization for 90+ new codes across multiple categories including durable medical equipment, hearing services, inpatient facility services, and outpatient diagnostics/services, effective August 1, 2026. Prior authorization will be mandatory for all nonparticipating providers and inpatient service requests.
High impact
Medical Policy Updates for June 2026
Blue Cross Blue Shield of Massachusetts·Effective Jun 1, 2026
Blue Cross Blue Shield of Massachusetts issued comprehensive policy updates effective June 1, 2026, affecting multiple specialties with new prior authorization requirements, coverage changes, and updated genetic testing guidelines. Key changes include new prior auth requirements for brain imaging CPT 70472, spine surgery smoking cessation documentation requirements, and several procedures moving from investigational to medically necessary status.
High impact
Prior Authorization Changes to Oncology-related Codes
Highmark·Effective May 1, 2026
Effective May 1, 2026, Highmark is adding 115 oncology-related codes to their prior authorization requirement list, including common chemotherapy medications and radiation therapy procedures. All authorization requests for these codes must be submitted electronically through Availity Essentials and will be reviewed by Evolent as part of Highmark's oncology value-based care strategy.
High impact
2026 January Medical Policy Updates
BlueCross BlueShield of South Carolina·Effective Jan 1, 2026
BlueCross BlueShield of South Carolina and BlueChoice HealthPlan released 35 updated medical policies effective January 2026, with the most critical changes being: (1) CPT code additions/deletions across multiple specialties effective 01/01/2026, (2) new investigational statements for Tibial Nerve Stimulation and Extracranial Carotid Artery Stenting, and (3) updated coverage denials for specific liver transplant indications. Most policies underwent annual reviews with no intent changes, but coding section updates require immediate billing system modifications.
High impact
Medical Policy Update December 31, 2025
Blue Cross NC·Effective Jan 1, 2026
Blue Cross NC updated multiple medical policies effective January 1, 2026, with extensive billing code changes including new CPT codes for IMRT procedures, archived spine-related policies, updated genetic testing codes, and new skin substitute codes. Most changes involve updating billing systems with new procedure codes while removing outdated ones.
Medium impact
Superficial Radiation Treatment - MEDICAID - FLORIDA (New)
Humana·Effective Apr 6, 2026
Humana Florida Medicaid now covers superficial radiation therapy (SRT) for treating non-melanoma skin cancers when surgery is contraindicated or refused, but specifically excludes image-guided superficial radiation therapy. This is a new policy establishing coverage for specific CPT codes with clear limitations.
Medium impact
Superficial Radiation Therapy - Medicare Advantage (Revised)
Humana·Effective Mar 10, 2026
Humana Medicare Advantage has updated its Superficial Radiation Therapy policy effective March 10, 2026, introducing new CPT codes (77436, 77437, 77438, 77439) that become active January 1, 2026. The policy establishes coverage criteria for treating nonmelanoma skin cancers with SRT, following Medicare Administrative Contractor guidelines.
Medium impact
Superficial Radiation Therapy - MEDICAID - VIRGINIA (New)
Humana·Effective Mar 9, 2026
New Medicaid Virginia policy establishes coverage for superficial radiation therapy (CPT 77436-77438) for nonmelanoma skin cancer when surgery is not an option, but explicitly excludes coverage for image-guided superficial radiation therapy (CPT 77439).
Medium impact
Superficial Radiation Therapy - MEDICAID - SOUTH CAROLINA (New)
Humana·Effective Mar 9, 2026
Humana has established a new Medicaid policy in South Carolina covering superficial radiation therapy (SRT) for nonmelanoma skin cancers when surgery is contraindicated or refused. The policy specifically excludes coverage for image-guided superficial radiation therapy due to insufficient evidence.
Medium impact
Superficial Radiation Therapy - MEDICAID - MICHIGAN (New)
Humana·Effective Mar 9, 2026
Humana Medicaid in Michigan now covers superficial radiation therapy (SRT) for nonmelanoma skin cancers when surgery is contraindicated or refused, but explicitly excludes image-guided SRT. This establishes new coverage for standard SRT procedures while setting clear limitations on advanced imaging-guided treatments.
Medium impact
Electronic Brachytherapy for Nonmelanoma Skin Cancer
Blue Cross & Blue Shield of Mississippi·Effective Jan 1, 2026
BCBS updated their policy on electronic brachytherapy for nonmelanoma skin cancer, adding new CPT codes 77436-77439 effective January 1, 2026, while deleting code 0394T as of December 31, 2025. The treatment remains classified as investigational and not covered.
Medium impact
25-1395 Radiation Oncology Code Update - Finalized Codes Effective January 1, 2026
Health Net·Effective Jan 1, 2026
Health Net has finalized placeholder radiation oncology CPT codes effective January 1, 2026. Three new CPT codes (77437, 77438, 77439) will require prior authorization through EviCore, and one code (77014) has been deleted.
Medium impact
2026 January Medical Policy Updates
BlueCross BlueShield of South Carolina·Effective Jan 1, 2026
BlueCross BlueShield of South Carolina updated 34 medical policies effective January 1, 2026, primarily involving annual reviews and CPT code changes. Multiple policies added new codes while deleting outdated ones, with most changes having no impact on coverage intent.

All billing codes J3590 99213 99212 99202 99214 99203

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[Ohio] Prior authorization requirement updates — Carelon Medical Benefits Management

Superficial Radiation Therapy - Medicare Advantage (Revised)

[Georgia] Prior Authorization Requirement Update

Medical Policy Updates for June 2026

Prior Authorization Changes to Oncology-related Codes

2026 January Medical Policy Updates

Medical Policy Update December 31, 2025

Superficial Radiation Treatment - MEDICAID - FLORIDA (New)

Superficial Radiation Therapy - Medicare Advantage (Revised)

Superficial Radiation Therapy - MEDICAID - VIRGINIA (New)

Superficial Radiation Therapy - MEDICAID - SOUTH CAROLINA (New)

Superficial Radiation Therapy - MEDICAID - MICHIGAN (New)

Electronic Brachytherapy for Nonmelanoma Skin Cancer

25-1395 Radiation Oncology Code Update - Finalized Codes Effective January 1, 2026

2026 January Medical Policy Updates