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Code deleted. See G0563.

Official Description

Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions
Short Descr Sbrt w/positron emission del
Coverage Special coverage instructions apply
Pricing Indicator(s) 53 – Statute
MPI A – Not applicable, as HCPCS priced under one methodology
Statute 1833(T)
Cross-Reference(s) G0563
BETOS P7A – Oncology - radiation therapy
TOS Code(s) 6 – Therapeutic radiology
Added Date 1/1/2024
Action Code D – Discontinue procedure or modifier code (effective 1/1/2025)
Termination Date 12/31/2024
APC Status Indicator Procedure or Service, Not Discounted when Multiple
MUE 1
MUE Not applicable/unspecified.
OTS Orthotic No
Date
Action
Notes
2026-01-01 Deleted First appearance of deletion in codebook.
2024-12-31 Deleted Code deleted. See G0563.
2024-01-01 Added Code added.
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