Molina HealthCare Idaho policy
Image Guided Radiation Therapy
Image Guided Radiation Therapy is a public Molina HealthCare Idaho policy (effective Aug 4, 2025). It lists 5 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
View the original policy (PDF) ↗
- Effective
- Aug 4, 2025
- Line of business
- Medicaid
- States
- AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NV, NY, OH, SC, TX, WI
- Source
- www.molinahealthcare.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes.
| Code | Other Molina HealthCare Idaho policies |
|---|---|
| 77014 | Policies naming 77014 |
| 77387 | Policies naming 77387 |
| G6001 | Policies naming G6001 |
| G6002 | Policies naming G6002 |
| G6017 | Policies naming G6017 |