Radiation oncology billing hinges on treatment planning 77306/77307 selection, IMRT 77338 with 77301 planning capture, SBRT 77373, and the 26/TC split on physics and dosimetry. Add course-of-treatment management 77401-77417 and brachytherapy 77761-77789 bundling, and general billers miss revenue on every fraction. MedFactor delivers radiation-onc-specific RCM that protects every claim.
From external beam and IMRT to brachytherapy and proton therapy, we tailor billing to the coding rules of every radiation oncology subspecialty.
3D-CRT and IMRT delivery (77338), treatment planning (77301/77306/77307), and dose calculation (77300) with correct complexity selection.
Stereotactic body radiation therapy (77373) and cranial SRS with hypofractionated delivery, special physics, and image-guidance capture.
Low-dose-rate and high-dose-rate brachytherapy (77761-77789), source placement, and radiopharmaceutical bundling accuracy.
Proton beam delivery codes, treatment planning, and special physics reimbursement with payer-specific prior authorization.
Age-based treatment planning, anesthesia-supported delivery, and complex hypofractionated regimens with pediatric coding accuracy.
Short-course palliative fractions, hypofractionated regimens, and course-management billing (77401-77417) by complexity level.
A radiation therapy course is billed as simulation, treatment planning, dose calculation, treatment devices, daily treatment delivery, and course management — with physics and dosimetry separately reportable under modifier 26/TC. Miss one link and the entire course is underbilled. This is the largest source of radiation oncology revenue loss.
Each course links a CT-simulation base to treatment planning, dose calculation, treatment devices, daily delivery, and course management — with physics/dosimetry billed separately under 26/TC.
Radiation oncology billing is governed by treatment-planning complexity selection, IMRT planning capture, and 26/TC physics splits that general billing companies cannot navigate effectively.
Simple (77306) and complex (77307) treatment planning selected incorrectly, under-capturing complex IMRT plan work or triggering downcode denials.
IMRT delivery (77338) billed without the IMRT planning (77301) add-on, losing the planning component revenue on every IMRT course.
Stereotactic body radiation therapy (77373) underbilled as standard delivery or denied for missing special-physics and image-guidance support.
Dose calculation (77300) and treatment devices (77332/77334) billed globally instead of split per payer 26/TC rules, losing one component.
Complex management codes (77401-77417) downcoded to basic management (77418), losing the per-fraction complexity differential.
Brachytherapy source placement and management codes (77761-77789) denied as bundled when distinct procedures aren’t reported with the correct modifiers.
Quick reference for the most frequently used codes in radiation oncology billing and coding.
| Code | Description | Common Use |
|---|---|---|
| 77014 | CT for treatment guidance (simulation) | CT simulation base |
| 77280 | Therapeutic radiology simulation, simple | Simple simulation |
| 77290 | Therapeutic radiology simulation, intermediate | Intermediate simulation |
| 77295 | Therapeutic radiology simulation, complex | Complex simulation / 3D |
| 77300 | Basic radiation dosimetry calculation | Dose calculation |
| 77301 | IMRT treatment plan | IMRT planning add-on |
| 77306 | Treatment plan, simple | Simple treatment planning |
| 77307 | Treatment plan, complex | Complex treatment planning |
| 77332 | Treatment devices, simple | Simple immobilization / blocks |
| 77334 | Treatment devices, complex | Complex collimator / multileaf |
| 77338 | IMRT delivery, multileaf collimator | IMRT treatment delivery |
| 77373 | Stereotactic body radiation therapy delivery | SBRT delivery |
| 77401-77417 | Radiation treatment delivery & management by complexity | Daily treatment / course management |
| 77761 | Brachytherapy, intracavitary, simple | Simple brachytherapy |
| 77789 | Brachytherapy, interstitial, complex | Complex interstitial brachytherapy |
| Code | Description | Clinical Context |
|---|---|---|
| C00-C96 | Malignant neoplasms | Primary cancer indication for radiation |
| Z51.11 | Encounter for antineoplastic chemotherapy | Concurrent chemo encounter |
| Z51.12 | Encounter for radiation therapy | Active radiation course encounter |
| C7A.0x | Malignant neuroendocrine tumor | Neuroendocrine malignancy radiation |
| C7B.0x | Secondary neuroendocrine tumor | Neuroendocrine metastasis |
| D49.0 | Neoplasm of unspecified behavior | Uncertain-behavior lesion pre-biopsy |
| Z85.x | Personal history of malignant neoplasm | Post-treatment surveillance |
| Z00-Z13 | Encounter for screening / general exam | Screening encounters |
| C50.x | Malignant neoplasm of breast | Breast cancer radiation |
| C61 | Malignant neoplasm of prostate | Prostate SBRT / IMRT |
| Modifier | Description | Radiation Oncology Application |
|---|---|---|
| 26 | Professional component | Physics / dosimetry interpretation (77300/77301/77332/77334) |
| TC | Technical component | Physics / dosimetry equipment & calculation |
| 59 | Distinct procedural service | Distinct brachytherapy procedures same session |
| 52 | Reduced services | Reduced fractional delivery |
| 22 | Increased procedural service | Unusually complex treatment planning |
| 53 | Discontinued procedure | Discontinued treatment course |
| 76 | Repeat procedure by same physician | Repeat simulation / planning same course |
| 77 | Repeat procedure by another physician | Repeat treatment by different provider |
Comprehensive revenue cycle management designed specifically for radiation oncology practices.
Specialty coders handle treatment-planning complexity (77306/77307), IMRT 77338 + 77301, SBRT 77373, and 26/TC physics splits with accuracy.
Treatment-planning downcode defense, IMRT planning-capture corrections, and appeals with dosimetry documentation for radiation denials.
Pre-treatment authorization for IMRT, SBRT, proton therapy, brachytherapy, and complex hypofractionated regimens.
Prioritized follow-up on aged treatment-planning, IMRT, and brachytherapy claims with strategic payer escalation to maximize recovery.
Regular audits focused on treatment-planning complexity, modifier 26/TC splits, IMRT planning capture, and course-management coding.
Real-time dashboards tracking IMRT/SBRT volume, treatment-planning complexity mix, and per-fraction capture by physician.
Understanding the most common denial reasons is the first step to preventing them on treatment-planning, IMRT, and brachytherapy claims.
Complex treatment planning (77307) downcoded to simple (77306) for lack of documentation, losing the planning differential.
Complexity-tier documentation with dosimetry support so 77307 is defended on every complex plan.
IMRT delivery (77338) billed without IMRT planning (77301), losing the planning component on every IMRT course.
Automatic 77301 pairing with every 77338 IMRT delivery so the planning component is captured.
Dose calculation (77300) and devices (77332/77334) billed globally instead of split per payer 26/TC rules.
Payer-specific 26/TC splits on every physics and dosimetry claim so neither component is lost.
Brachytherapy source placement and management (77761-77789) denied as bundled when distinct procedures lack modifier 59.
Modifier 59 for distinct brachytherapy procedures same session, preserving separate placement and management revenue.
Identifying and plugging these common revenue leakage points can significantly improve your practice’s bottom line.
77301 IMRT planning not billed alongside 77338 delivery, losing the planning fee per course.
Technical component on dosimetry (77300/77334) not split out where the payer requires 26/TC.
SBRT (77373) billed as standard delivery, losing the stereotactic delivery differential per fraction.
Complex management (77401-77417) downcoded to basic 77418, losing the per-fraction complexity differential.
See how radiation-oncology-specific revenue cycle management transforms your practice’s financial performance.
A structured onboarding process designed to deliver measurable improvements within the first 90 days.
Review of radiation oncology billing operations, treatment-planning capture, IMRT planning pairing, and revenue cycle baseline.
EMR and oncology-system integration, dedicated radiation onc billing team, and payer enrollment verification.
Full billing with real-time claim submission, 26/TC modifier verification, and denial prevention protocols.
Performance review against baseline, workflow optimization, and documented revenue improvement.
How our radiation-oncology-specific approach compares to in-house billing and general medical billing companies.
| Capability | In-House Team | General Billing Co. | MedFactor Radiation Onc |
|---|---|---|---|
| Treatment-planning complexity (77306/77307) | Inconsistent | ✕ | ✓ |
| IMRT 77338 + 77301 planning capture | ✕ | ✕ | ✓ |
| SBRT 77373 capture | Inconsistent | ✕ | ✓ |
| Physics / dosimetry 26/TC splits | Inconsistent | ✕ | ✓ |
| Course-management 77401-77417 tiering | Manual | Partial | ✓ |
| Brachytherapy 77761-77789 bundling | Inconsistent | Partial | ✓ |
| Proton / SBRT prior auth | Manual | Partial | ✓ |
| Treatment-planning complexity reporting | ✕ | ✕ | ✓ |
| Dedicated radiation onc billing team | ✕ | ✕ | ✓ |
Our team combines deep radiation oncology billing expertise with the technology and processes to deliver consistent, measurable results for treatment-planning, IMRT, and brachytherapy practices.
Discover exactly where your radiation oncology practice is losing revenue. Our no-obligation audit analyzes your treatment-planning capture, IMRT planning pairing, and 26/TC modifier compliance.
Real results from radiation oncology practices that partnered with MedFactor for specialty revenue cycle management.
A community linac center was billing IMRT delivery (77338) without the 77301 planning add-on and under-capturing complex treatment planning (77307). MedFactor implemented automatic 77301 pairing and complexity-tier documentation, recovering substantial planning revenue in seven months.
A hospital-based SBRT program was billing stereotactic delivery (77373) as standard delivery and missing special-physics reimbursement. MedFactor implemented SBRT-specific coding with image-guidance support, recovering the stereotactic differential per fraction.
A brachytherapy practice was losing source-placement revenue to bundling denials on 77761-77789. MedFactor implemented modifier 59 for distinct procedures and correct 26/TC splits on physics, protecting brachytherapy component revenue.
No matter where your radiation oncology practice operates, our team understands the payer landscape and regulatory requirements in your region.
Deep coding knowledge across Medicare, Medicaid, and all major commercial payers for radiation therapy services.
26/TC component rules for physics and dosimetry applied correctly across all 50 states.
Facility and professional billing coordination across hospital-based and freestanding linac centers.
State Medicaid pediatric radiation coverage and complex hypofractionated regimen rules.
Common questions from radiation oncology practices considering MedFactor’s specialty RCM services.
Treatment planning is billed by complexity: 77306 (simple) covers standard single or opposed-field plans with basic dose calculation, while 77307 (complex) covers multi-field, conformal, or IMRT-adjacent plans requiring detailed dosimetry and beam shaping. The complexity tier is determined by the number of treatment fields, use of blocking or multileaf collimation, and the dosimetric complexity of the plan. We document the planning detail — field count, image fusion, dose-volume histograms, and organ-at-risk constraints — so the complex tier (77307) is defended on every complex plan rather than downcoded to simple for lack of documentation.
IMRT delivery (77338) is the technical delivery of intensity-modulated radiation through a multileaf collimator, and IMRT treatment planning (77301) is the separate planning activity that generates the fluence maps and optimization. The 77301 is billed once per IMRT course in addition to the treatment-planning code (77306 or 77307), and 77338 is billed for the delivery. We pair 77301 with every 77338 IMRT course so the planning component is captured — the most common IMRT revenue loss is billing the delivery without the planning add-on.
Stereotactic body radiation therapy (77373) covers the delivery of SBRT hypofractionated courses and is reported per course (not per fraction) for Medicare. It requires special physics support, image guidance, and motion management that must be documented to support the stereotactic differential over standard delivery. Some payers prefer a per-fraction delivery code for SBRT instead of 77373, so we verify the payer’s SBRT billing policy before submission. We capture the special-physics and image-guidance components so SBRT is paid at the stereotactic rate rather than downcoded to standard delivery.
Dose calculation (77300), IMRT planning (77301), and treatment devices (77332/77334) have a professional component (physics interpretation and plan review, modifier 26) and a technical component (dosimetry calculation and equipment, modifier TC). When a physicist interprets dosimetry performed by a dosimetrist or outside facility, only the 26 is billed. When the practice owns the planning system and performs the calculation, the TC or global is billed per payer rules — Medicare requires the components split when a facility is involved. We apply the correct 26/TC split per payer on every physics and dosimetry claim so neither component is lost to a global-only denial.
Radiation treatment delivery and management (77401-77417) is tiered by complexity — the code selected reflects the complexity of the treatment delivery (number of fields, blocks, special dosimetry, image guidance) and is reported per fraction or per course depending on the code. The complex management codes (77413-77417) carry a higher reimbursement than the basic management code (77418) which covers simple single-field treatments. Downcoding complex management to 77418 loses the per-fraction complexity differential. We code each management claim to the correct complexity tier with supporting documentation of field count, blocking, and image guidance so the complex codes are defended.
Brachytherapy codes 77761-77789 cover intracavitary and interstitial brachytherapy by complexity (simple, intermediate, complex) and include source placement, dosimetry, and management. Distinct brachytherapy procedures performed in the same session — such as separate source placements or separate dosimetry calculations — must be reported with modifier 59 (distinct procedural service) or they are denied as bundled. We verify the NCCI edit pairs before submission and apply modifier 59 for legitimately distinct procedures so brachytherapy source-placement and management revenue is preserved rather than denied as bundled.
MedFactor applies the same code-level precision across the full practice spectrum. See how we bill these related specialties.
CPT®, ICD-10, HCPCS, and modifier codes referenced on this page reflect the current code sets and are subject to annual updates — always verify against the current-year fee schedule before submission. KPIs and case-study figures shown are representative benchmarks, not guarantees of individual practice results.
Your radiation oncology practice deserves billing partners who know treatment-planning 77306/77307 complexity, IMRT 77338 + 77301 pairing, SBRT 77373, and 26/TC physics splits — and code every claim correctly. Let MedFactor show you what specialty RCM can do.