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2026 Annual HCPCS Update: Impacted Oncology Radiation Treatment Procedure Codes

Date: 04/24/26

Effective January 1, 2026, the Centers for Medicare and Medicaid Services (CMS) updated radiation treatment procedure codes during the 2026 annual Healthcare Common Procedure Coding System (HCPCS) update.

As part of the annual update, 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:

G Codes

G6001

G6002

G6003

G6004

G6005

G6006

G6007

G6008

G6009

G6010

G6011

G6012

G6013

G6014

G6015

G6016

G6017

 

CMS did not provide a direct replacement for any of the discontinued codes.

The time available for payers and state programs to review and assess the effects of these changes was significantly shortened because of the federal government shutdown that occurred during the time when CMS would usually release the annual HCPCS file. As a result, the impact to claims and reimbursement was not fully evaluated before the changes took effect.

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.

Providers should note the following:

  • ·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.
  • 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 updates to address the issue remain in progress.
  • Claims submitted to Superior with newly covered codes will initially deny with EXcL, which has the explanation description “DENY: NEW CODE. DO NOT RESUBMIT – WILL BE AUTOMATICALLY PROCESSED.” This denial code is intentionally used when the State has announced new covered services, but the associated rates are still pending rate hearing approval and publication by HHSC.
  • Once HHSC posts the approved rates, Superior will remove the EXcL denial logic, load the authorized rates, and systematically reprocess all impacted claims to adjudicate and pay at the appropriate rate. Providers do not need to resubmit these claims, as the adjustment will occur automatically.

HHSC will publish additional information about claims submission, and any additional steps providers may need to take. For more information, call the Texas Medicaid & Healthcare Partnership (TMHP) Contact Center at 1-800-925-9126.