G0339 prior authorization | Blue Cross and Blue Shield of Montana

G0339, Image-Guided Robotic Linear Accelerator- Based Stereotactic Radiosurgery Complete Course Of Therapy In One Session Or First Session Of Fractionated Treatment, is on the Blue Cross and Blue Shield of Montana commercial prior authorization list. Not a coverage or referral decision.

Code: G0339
Description: Image-Guided Robotic Linear Accelerator- Based Stereotactic Radiosurgery Complete Course Of Therapy In One Session Or First Session Of Fractionated Treatment
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 263 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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