Radiation Oncology Billing Experts

Radiation Oncology Medical Billing Services

Radiation oncology billing involves treatment planning, simulation, and delivery codes that must be documented with precision across the entire course of therapy.

Get Your Free Assessment Explore the Guide
Radiation Oncology Medical Billing Services
95%

First-pass claim acceptance

32 days

Average days in A/R

18%

Revenue recovery improvement

99.2%

Fraction billing accuracy

Overview

Revenue Cycle Solutions for Radiation Therapy Departments

Radiation oncology billing involves treatment planning, simulation, and delivery codes that must be documented with precision across the entire course of therapy. Treatment planning codes (77261-77263, simple through complex) depend on the number of treatment areas and the complexity of blocking and dose calculation. Simulation codes (77280-77295) are separate from planning and must not be confused or bundled together.

Daily treatment delivery codes vary by modality: IMRT (77385-77386), 3D conformal (77412), proton therapy (77520-77525), and stereotactic radiosurgery (77371-77373) each have distinct requirements. Weekly management codes (77427) cover physician oversight and can be billed only for completed weeks of five fractions. Partial weeks at the end of treatment are prorated, and billing a full management code for fewer than five fractions triggers denials.

Revenue Cycle Solutions for Radiation Therapy Departments
Challenges

Common Radiation Oncology billing Challenges We Solve

Every Radiation Oncology billing team deals with payer delays, coding nuance, and collection leakage.

Multi-Fraction Treatment Billing

A standard radiation course involves 25-35 daily fractions, each requiring individual claim submission with correct technique codes. Managing this volume while preventing duplicate billing or missed fractions is operationally demanding.

Treatment Planning Code Complexity

Planning codes (77263 complex planning, 77280-77295 simulation, 77300 dosimetry) must align with documented clinical complexity. Undercoding the planning phase undervalues the significant physics and physician work involved.

Payer Authorization for Advanced Modalities

IMRT (77385-77386), SBRT (77373), and proton therapy (77520-77525) require prior authorization from most payers, with clinical justification demonstrating superiority over conventional techniques for the specific tumor site.

Bundling Edits and Modifier Requirements

CCI edits frequently bundle image guidance (77387) with treatment delivery and physics charges with planning services. Correct modifier application is essential to capture all billable components without triggering compliance flags.

Services

Complete Radiation Oncology billing Services

Support spans the full revenue cycle.

Daily treatment fraction billing and tracking

Treatment planning and simulation coding

IMRT, SBRT, and proton therapy reimbursement

Prior authorization for advanced radiation modalities

Physics and dosimetry charge management

Weekly management and concurrent therapy billing

Coverage

Serving Radiation Oncology billing Teams Nationwide

We support independent practices and growing provider organizations.

Independent physician groups

Multi-location practices

Private equity backed platforms

Hospital-owned outpatient groups

Guide

The Complete Guide to Radiation Oncology billing

Radiation oncology billing ranks among the most technically demanding specialties in healthcare reimbursement. Treatment planning codes (77263 for complex planning, 77280-77295 for simulation), delivery codes for IMRT (77385-77386), SBRT (77373), and proton beam therapy (77520-77525) each carry distinct documentation and authorization requirements. A single patient course of radiation can generate 30 or more billable fractions, and each fraction must be coded with the correct technique, body site, and treatment parameters to avoid bundling denials.

Our billing team handles the complete radiation oncology revenue cycle, from initial consultation coding (99201-99215 with oncology-specific documentation) through treatment planning, daily treatment delivery, and weekly management (77427). We manage the physics and dosimetry charges (77300, 77306-77321), image guidance codes (77014, 77387), and the special handling required for concurrent chemotherapy billing. For practices offering newer modalities like stereotactic radiosurgery or adaptive radiation therapy, we stay current with evolving code sets and payer coverage policies to protect your reimbursement on advanced treatments.

Common Questions

Frequently Asked Questions About Radiation Oncology billing

Answers to the questions practice owners ask most often.

We maintain a fraction-by-fraction tracking system that logs each daily treatment, verifies the technique code matches the treatment plan, and flags any gaps or duplicate submissions. At treatment completion, we reconcile total fractions billed against the prescribed course to ensure nothing is missed.

We submit prior authorization requests with clinical documentation that demonstrates tumor location, proximity to critical structures, and published evidence supporting the selected modality. For SBRT (77373), we include the treatment plan showing dose conformality and fractionation schedule that payers require for approval.

We coordinate radiation billing with medical oncology chemotherapy charges, ensuring correct date-of-service alignment, proper use of modifier 59 for distinct services, and separate claim submission pathways for the radiation and infusion components.

Yes. We code basic dosimetry (77300), isodose plan review (77306-77307), teletherapy isodose planning (77316-77321), and special physics consultations with appropriate documentation linking each charge to the treatment plan.

Proton therapy codes (77520-77525) face coverage variability across payers. We verify coverage before treatment begins, submit clinical justification based on tumor type and published comparative data, and manage appeals when initial authorization requests are denied.

Our radiation oncology clients typically recover 12-18% more revenue through accurate planning code capture, elimination of missed fractions, and successful authorization of advanced modalities. Average days in A/R decrease from 55 to 32 days.

READY TO GET STARTED?

Start Billing Smarter for Radiation Oncology billing

Get a revenue review and a clear action plan tailored to your practice.

Get Your Free Assessment

HIPAA Compliant · No Upfront Fees · No Long-Term Contracts