Oncology Radiation Treatment Procedure Codes Impacted by 2026 Annual HCPCS Update

Call to action: The purpose of this communication is to inform providers that as part of the annual update, the Centers for Medicare and Medicaid Services (CMS) discontinued previously active procedure codes 77014, 77385, and 77386 and the following G codes for claims for image-guidance services in offices and clinics. CMS did not provide a direct replacement for any of the discontinued codes.

Background: Effective January 1, 2026, CMS updated radiation treatment procedure codes during the 2026 annual Healthcare Common Procedure Coding System (HCPCS) update.

How this impacts providers:

• The Texas Health and Human Services Commission (HHSC) recognizes the impact that this issue has on providers and members who are receiving services and is actively working to address the issue of continued coverage for these services.
• HHSC has submitted a Medicaid State Plan Amendment to CMS with a requested effective date of January 1, 2026.
• HHSC will also be holding a Rate Hearing on April 24, 2026 to propose changes that are intended to address the impact of the discontinued codes. 
  • Rate hearing announcements are posted on the Texas HHS Meetings & Events web page and rate hearing packets are available on the Provider Finance Department’s web page.
• CMS now allows reimbursement for these affected services using procedure codes 77402, 77407, and 77412 in the office and clinic setting. 
• Currently, HHSC asks impacted providers to submit timely claims using the most appropriate codes (77402, 77407, or 77412) while the necessary system updates to address the issue remain in progress. 
  • Given the CMS HCPCS update on January 1, 2026, the earliest 95-day deadline approaching for claims filing will be Monday, April 6, 2026.
  • Although HHSC asks all impacted providers to submit timely claims for these services, be aware they may continue to be denied for impacted billing providers using codes 77402, 77406, or 77412 in the office or clinic setting until all updates can be finalized following the required CMS approvals and the HHSC rate hearing.
• HHSC will publish additional information about claims submission and any additional steps providers or MCOs may need to take.

Next step for Providers: Providers should share this information with their billing staff.

If you have any questions, please email Provider Relations at providerrelations@texaschildrens.org.

For access to all provider alerts www.texaschildrenshealthplan.org/provideralerts.