Radiation Oncology Billing Services for Cancer Centers

Our radiation oncology billing services cover planning, simulation, daily delivery, and weekly physician management, with clear documentation for each phase of a course.

CONSULT OUR TEAM ON RADIATION ONCOLOGY BILLING

Radiation Oncology Billing Services for
Each Treatment Course

Radiation oncology billing services track a patient over several weeks, not a single visit. One course can include a consult, clinical treatment planning, CT simulation, an IMRT plan, physics checks, daily image-guided delivery, and weekly management by the physician. Each step carries its own code, frequency limit, and professional or technical split. Pyramids Global matches your center with certified coders who track the full course from the opening consult through the last fraction, so each claim reflects the planning and treatment your team delivered.

Radiation oncologist explaining a care plan to a cancer patient

Why Radiation Oncology Claims Call for Extra
Attention and Care

Radiation therapist positioning a patient on a linear accelerator table

Radiation therapy coding changes with the payer and the setting. Medicare uses HCPCS G-codes, such as G6015 for IMRT delivery, in freestanding centers, while many commercial plans accept CPT codes such as 77385 and 77386. Weekly treatment management (77427) is billed once for every five fractions, and medical physics support (77336) is billed weekly. Hospital-based physicians bill the professional component with modifier 26, while freestanding centers may bill globally. Many commercial plans also route IMRT, SBRT, and proton therapy through a benefit manager for prior approval. Our radiation oncology billing services weigh every one of these rules before a claim goes out.

Medical coder reviewing radiation therapy charges on a computer screen

Common Revenue Leaks in Radiation Therapy
and Our Fix for Each

A single treatment course can include dozens of charges, so small gaps add up quickly. In radiation oncology billing, payments are most often lost in these four places during a course:

CPT and Medicare G-Code Mix-Ups

Delivery and image guidance are billed with G-codes for Medicare in many settings and with CPT codes for other payers. Using the wrong code set for a patient’s plan leads to rejections across every fraction. Our coders map each patient’s payer to the correct delivery and IGRT codes before charges are posted.

77427 Fraction Count Errors

Code 77427 covers five fractions of physician management, and the physician documents at least one patient visit for each unit. Leftover fractions at course end follow specific CPT rules, so miscounting leads to overbilling or lost units. We reconcile fraction logs with management charges every week.

Planning Codes Without Support

Clinical treatment planning, simulation, dosimetry, and device codes each need signed documentation that matches the plan. Missing physician signatures, dates, or plan approvals are a common finding in payer audits and medical reviews. Our team checks each planning record before release.

IMRT and SBRT Approvals

IMRT, SBRT, brachytherapy, and proton therapy often need prior authorization, sometimes through a radiation benefit manager. A plan change mid-course, such as a boost or added fractions, can also require a new approval. We track each authorization against the delivered technique and fraction count.

From Consult to Final Fraction:
The Radiation Therapy Billing Workflow

We follow each patient from consult and eligibility checks through planning, simulation, daily treatment, on-treatment visits, follow-up care, and the final payment on the account.

Planning, Delivery, and Physics Coding

Our coders assign codes for clinical treatment planning (77261 to 77263), simulation, 3D or IMRT dosimetry, treatment devices, daily delivery, and IGRT, then apply modifier 26 or TC where the professional and technical parts are billed separately.

Benefits and Authorization
Checks

Before simulation, we confirm coverage, deductibles, out-of-pocket limits, and authorization rules for the planned technique and fraction count, and request approval when required. Authorization numbers are linked to each claim.

Charge Reconciliation and
Appeals

Daily treatment records are matched with posted charges, and denied claims are corrected or appealed with treatment plans, prescriptions, and physics notes. Payer-level denial trends reach your office every month.

Care Teams Focused on Treatment Quality

Radiation oncologists, physicists, and dosimetrists already manage complex plans every day. Moving billing tasks to our side lets your care team stay focused on patients, plan review, and treatment quality.

Why Radiation Therapy Centers and Physician
Groups Choose Us

Over 500 practices in 20+ specialties have billed through Pyramids Global since 2013. Freestanding centers, hospital physician groups, and cancer clinics gain these strengths from radiation oncology billing services:

Coders Who Know Radiation Codes

Treatment planning, delivery, IGRT, brachytherapy, and physics codes, along with Medicare G-code rules, are everyday tasks for the certified coders on our team, who review each year’s updates.

A Dedicated Account Manager

A named account manager gets to know your physicians, treatment machines, and insurers, giving your staff a single point of reach for claims, authorizations, and charges.

Professional and Technical Splits

Whether you bill globally, professionally, or technically by site, we match modifiers and place of service to each arrangement, so hospital and freestanding claims stay aligned.

Reporting by Course and Physician

Monthly reports break down payments, top denial reasons, unpaid accounts, and charges per treatment course by physician and site, helping leaders review capacity and payer trends.

Our Track Record as Averages

As averages across client accounts, coding accuracy is 98%, first-pass acceptance is 99%, 86% of collections arrive in 30 days, and denials are typically under 2%.

Accuracy Checks Behind Radiation Oncology Claims

Radiation charts include plans, prescriptions, physics checks, and daily treatment records. Before any claim is released, our coders compare codes, units, modifiers, and dates against these records on each radiation oncology course, which helps catch one missed fraction or signature before it affects many charges.

Cancer centers relying on radiation oncology billing services with our team receive coding rationale in writing, a monthly view of payer behavior, and documentation organized for audits or medical reviews. Billing stays consistent across external beam therapy, SBRT, brachytherapy, and follow-up care after treatment ends.

Pyramids Global coders studying radiation oncology billing services reports

Supporting Services for Radiation Therapy Centers

Radiation therapy revenue also leans on correct coding, fast approvals, and current physician enrollment, and the American Society for Radiation Oncology publishes coding guidance that many centers use for documentation. Beside radiation oncology billing services, we also handle:

- Certified coding for planning, simulation, delivery, IGRT, physics, and follow-up visits

- Prior authorization services for IMRT, SBRT, proton therapy, and brachytherapy, typically initiated within 30 minutes

- Credentialing services for radiation oncologists in Medicare, Medicaid, and commercial networks across 21 states

- Premium Practice Audit of fraction counts, planning records, physics charges, and G-codes

Radiation Oncology Billing Services – Questions Practices Often Ask

What shapes the pricing of radiation oncology billing support from Pyramids Global?

Pricing is shaped by your number of treatment courses, your patients’ insurance coverage, and the services you need. No setup charge is added, and a free consultation with our billing team covers the details.

Which parts of a course do your radiation oncology billing services cover?

We bill the full treatment course, from consults and planning to delivery and follow-up. This includes CT simulation, 3D and IMRT planning, IGRT, SBRT, SRS, HDR and LDR brachytherapy, proton therapy, medical physics support, and weekly treatment management.

How is weekly treatment management (77427) billed?

Code 77427 is billed once for every five fractions delivered. Under CPT rules, three or four fractions left at the end of a course are billed as one more unit, while one or two leftover fractions are not billed separately and fold into the prior week.

What are typical timelines for radiation therapy approvals?

Expedited approvals usually take 24 to 72 hours, while standard approvals take 7 to 14 business days. Our authorization staff typically starts each request within 30 minutes after an order is received.

Does our center have to replace its oncology software?

No, billing is handled within the EHR or oncology information system your center runs today. Each client practice signs a BAA, and treatment records and patient data are protected under HIPAA standards.

What reports do we receive after onboarding?

You receive monthly reports covering payments, denial reasons, unpaid balances, and course-level charges by physician and treatment site.

Book a Free Consultation on Your
Radiation Oncology Revenue

Rheumatology practice manager discussing revenue with a billing advisor

Rejected G-codes, unbilled management weeks, or delayed IMRT approvals point to gaps in radiation therapy billing. Our radiation oncology billing services begin by studying recent treatment courses. Since 2013, Pyramids Global has supported more than 500 practices across 20+ specialties, and a free consultation is the first step to see where your radiation oncology claims stand.

Our team can handle planning and delivery coding, eligibility checks, prior authorization, daily charge reconciliation, payment posting, appeals, and follow-up on open patient accounts for each treatment site. This gives your physicians, physicists, and dosimetrists more time for treatment planning and patient care.

CONSULT US FOR A RADIATION ONCOLOGY BILLING REVIEW